纵向胰肠吻合术治疗儿童慢性胰腺炎合并胰管扩张  

Longitudinal pancreaticojejunostomy for paediatric chronic pancreatitis with dilated pancreatic ducts

作　　者：邵天伟 张明满[1] 熊强[1] 陈柏林[1] Shao Tianwei;Zhang Mingman;Xiong Qiang;Chen Bailin(Department of Hepatobiliary Surgery,Children's Hospital of Chongqing Medical University,Key Laboratory of Child Development,and Disorders,Ministry of Education,China International Science and Technology Cooperation Base of Child Development and Critical Disorders,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院肝胆外科、儿童发育疾病研究教育部重点实验室、儿童发育重大疾病国家国际科技合作基地、儿科学重庆市重点实验室,重庆400014

出　　处：《中华肝胆外科杂志》2019年第2期116-119,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的分析胰肠吻合术治疗儿童慢性胰腺炎合并胰管扩张的疗效。方法回顾分析重庆医科大学附属儿童医院2011年12月至2017年1月采用纵向胰肠吻合术治疗的13例慢性胰腺炎合并胰管扩张患儿临床资料。对手术安全性、术后疗效、术后并发症及患儿术后生长发育等情况进行统计分析。结果13例患儿手术顺利。11例术后8天血尿淀粉酶恢复正常、腹痛症状完全消失;1例术后腹痛逐渐缓解,1年后腹痛消失,血尿淀粉酶逐渐恢复正常,生长发育较满意;1例患儿术前胰腺严重萎缩,术前术后高脂饮食,时有饮酒,术后腹痛反复,血淀粉酶时有升高,生长发育稍差。本组患儿无术后出血、胰漏及肠梗阻等并发症。与术前比较,术后1年13例患儿体重及身高的生长发育均有改善(P<0.05)。结论纵向胰肠吻合术治疗儿童慢性胰腺炎合并胰管扩张症安全、疗效确切,能有效缓解患儿症状,提高其生活质量,改善其生长发育。Objective To analyze the results of longitudinal pancreaticojejunostomy in treatment of paediatric chronic pancreatitis with dilated pancreatic ducts. Methods A retrospective study was carried out on 13 patients with paediatric chronic pancreatitis complicated with dilated pancreatic ducts treated with longitudinal pancreaticojejunostomy in Children's Hospital of Chongqing Medical University from December 2011 to January 2017. The perioperative morbidity and mortality rates, long-term treatment results and postoperative growth of these children were analyzed. Results The 13 patients all underwent successful surgery. In 11 patients, the serum and urine amylase levels returned to normal after 8 days of operation, and the abdominal pain disappeared completely. In 1 patient, the abdominal pain gradually disappeared in 1 year, and the serum and urine amylase levels gradually returned to normal. This patient gained weight well. In the remaining patient who had severe pancreatic atrophy, the patient took high-fat diets before and after surgery, and drank alcohol occasionally. The patient developed repeated attacks of abdominal pain with occasional increase in serum and urine amylase levels and had poor weight gain. There were no complications such as postoperative bleeding, pancreatic leakage and intestinal obstruction in this study. The body weight and growth rates of the whole group of patients before and 1 year after surgery were different. Conclusion Longitudinal pancreaticojejunostomy for paediatric chronic pancreatitis complicated with dilated pancreatic ducts was safe and effective in alleviating symptoms, improving quality of life, and resulted in normal growth of these children.

关 键 词：胰腺炎 慢性 胰管空肠吻合术 胰管扩张 治疗结果 

分 类 号：R726.5[医药卫生—儿科]