胰头部肿物局部切除后胰肠吻合治疗胰头部良性肿瘤  

Surgical experience on Roux-en-Y pancreaticojejunostomy after local pancreatic head resection for benign tumors of the pancreatic head

作　　者：原春辉[1] 叶辰[1] 陶明[1] 马朝来[1] 蒋斌[1] 李磊[1] 王亮[1] 王行雁[1] 陈亚希[1] 张同琳[1] 修典荣[1] 

机构地区：[1]北京大学第三医院普通外科,100191

出　　处：《中华外科杂志》2016年第5期376-379,共4页Chinese Journal of Surgery

摘　　要：目的探讨胰头局部切除联合胰肠Roux-en-Y吻合修补胰腺创面在治疗胰头部良性肿瘤方面的价值。方法回顾性分析2006年11月至2013年10月北京大学第三医院收治的12例施行胰头局部切除联合胰肠Roux-en-Y吻合修补胰腺创面患者的临床资料。男性5例，女性7例；年龄21～65岁，平均42．3岁。12例胰头部肿瘤最大径3．0-4．8cm，肿瘤切除后胰腺创面最大径5．1-7．9cm，其中1例有明确主胰管损伤。结果术中病理证实黏液性囊腺瘤2例，胰岛素瘤2例，实性假乳头状瘤3例，无功能内分泌肿瘤5例。12例患者术后均未发生胰瘘。围手术期无死亡。随访24～108个月（其中4例随访超过5年），均未发现复发征象，生活质量好，无糖尿病发生。结论对于胰头部良性肿瘤，在病例选择适当时，胰头局部切除联合胰肠Roux-en-Y吻合修补胰腺创面是一种较好的选择。Objective To explore the value of Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in treating benign tumors of pancreatic head （BTPH）. Methods The clinical data of 12 patients diagnosed as BTPH and treated by Roux-en-Y pancreaticojejunostomy after local pancreatic head resection in Department of General Surgery, Peking University Third Hospital from November 2006 to October 2013 were retrospectively analyzed. Of the 12 cases,5 patients were male,7 patients were female, the age of patients ranged from 21 to 64 years（ average 42. 3 years）. Diameter of tumors was 3.0 - 4. 8 cm. Diameter of pancreatic wound after resection was 5.1 - 7.9 cm, and main pancreatic duct injury happened in 1 case. Results Two cases of mucinous cystadenoma, 2 insulinoma, 3 solid pseudopapillary tumor and 4 nonfunctional pancreatic neuroendocrine tumors were confirmed histopathologically. No mortality and pancreatic leakage occurred during the perioperative period. All the 12 patients had no sign of recurrence. Experienced good life quality without occurrence of diabetes during the follow-up period of 24 - 108 months（ more than 60 months in 4 cases）. Conclusions Roux-en-Y pancreaticojejunostomy after local pancreatic head resection is a reasonable choice for benign tumors of the pancreatic head as long as the patient is properly selected.

关 键 词：胰腺肿瘤 外科手术 良性肿瘤 胰头部 局部切除 胰肠Roux-en-Y吻合 

分 类 号：R735.9[医药卫生—肿瘤]