胆管、胰管双T管架桥空肠内引流治疗晚期胰头癌39例分析  

Analysis of biliary-jejunal and pancreatic-jejunal double T-tube stent in the surgical treatment of advanced pancreatic head cancer in 39 cases

作　　者：姜皓[1] 施维锦[1] 

机构地区：[1]上海交通大学医学院附属仁济医院胆胰外科,上海200001

出　　处：《肝胆胰外科杂志》2015年第3期177-179,183,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的研究胆管、胰管双T管架桥术姑息治疗晚期胰头癌的应用价值。方法收集1999年10月至2013年10月我院共39例施行胆管、胰管双T管架桥术的临床资料,分析该术式的晚期胰头癌患者的手术时间、术中出血量、并发症发生率、术后住院天数、术后肝功能和腹痛恢复、生存时间等。结果平均手术时间(68.95±12.89)min;术中出血均少于50 m L,未输血;共发生12例胰瘘(30.77%),2例胆瘘(5.13%),均经引流后愈合;平均术后住院(13.87±2.55)d,无腹腔出血、感染等严重并发症。35例(89.74%)术后腹痛明显缓解;20例(100%)脂肪泻的患者均缓解。平均生存期(9.12±1.70)个月。结论胆管、胰管双T管架桥术手术简单安全、创伤小,能有效解患者胆道和胰管的梗阻症状,改善其生活质量。Objective To study the clinical value of biliary-jejunal and pancreatic-jejunal double T-tube stent in the surgical treatment of advanced pancreatic head cancer. Methods Between Oct. 1999 and Oct. 2013, 39 cases with advanced pancreatic head cancer were underwent biliary-jejunal and pancreatic-jejunal double T-tube stent,patients were retrospectively analyzed including operation duration, intraoperative blood loss, operation complications incidence, postoperative hospitalization, recovery of liver function and abdominal pain, and survival time.Results The average operation duration was（68.95±12.89） min, and intraoperative blood loss was less than 50 m L. No patients received blood transfusion. Twelve cases（30.77%） suffered from pancreatic fistula and 2 patients suffered from biliary fistula（5.13%）; however all of these patients recovered after drainage. The average postoperative hospitalization was（13.87±2.55） d, no severe complications were observed such as abdominal hemorrhage and infection. Thirty-five of the cases（89.74%） suffered from abdominal pain, and all of the 20 cases（100%） that suffered from steatorrhea were fully recovered. The average survival time was（9.62±1.70） months. Conclusion The treatment of biliary-jejunal and pancreatic-jejunal double T-tube stent operation is simple, safe and minimally invasive.This operation can reduce the obstruction symptoms of patients effectively and improve their quality of life.

关 键 词：胰头癌 姑息性手术 T管架桥 胰高压 

分 类 号：R735.9[医药卫生—肿瘤]