不同胰十二指肠切除术治疗胰头导管癌的临床效果比较  

Comparison of clinical effects of different pancreaticoduodenectomy in the treatment of ductal pancreatic head carcinoma

作　　者：李卓锴 张坤[1] 谭炜 郭敬强 涂朝勇[1] 朱锦德[1] LI Zhuokai;ZHANG Kun;TAN Wei;GUO Jingqiang;TU Chaoyong;ZHU Jinde(Department of Hepatobiliary and Pancreatic Surgery,Lishui Central Hospital in Zhejiang Province,Lishui323000,China)

机构地区：[1]浙江省丽水市中心医院肝胆胰外科,浙江丽水323000

出　　处：《中国现代医生》2021年第17期49-52,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2020ZB304)。

摘　　要：目的探讨不同胰十二指肠切除术治疗胰头导管癌的临床效果。方法选取2015年1月至2019年5月于我院诊治的胰头导管癌患者56例作为研究对象进行回顾性研究,分为观察组和对照组,每组各28例,观察组患者采用保留幽门胰十二指肠切除术(Pylorus-preserving pancreaticoduodenectomy,PPPD),对照组患者采用标准胰十二指肠切除术(Standard pancreaticoduodenectomy,SPD),比较两组患者的一般临床资料、术中及术后指标(术中出血量、手术时间、胃管留置时间及住院时间),并观察术后并发症的发生率(胃排空延迟、腹内感染、胆瘘及胰瘘)。结果两组患者年龄、性别、腹部手术史、体质量指数、总胆红素、血红蛋白和白蛋白水平比较,差异无统计学意义(P>0.05);两组患者的胃管留置时间和住院时间比较,差异无统计学意义(P>0.05);观察组患者的手术时间显著短于对照组,术中出血量显著低于对照组,差异有统计学意义(P<0.05);观察组患者术后并发症的总发生率为10.71%,对照组为14.28%,差异无统计学意义(P>0.05)。结论相较于标准胰十二指肠切除术,保留幽门的胰十二指肠切除术的手术时间较短、术中出血量较少,两种术式的安全性均较高。Objective To explore the clinical effects of different pancreaticoduodenectomy in the treatment of ductal pancreatic head carcinoma.Methods A total of 56 patients with ductal pancreatic head carcinoma who were diagnosed and treated in our hospital from January 2015 to May 2019 were selected as the research subjects for a retrospective study.They were divided into an observation group and a control group,with 28 cases in each group.Patients in the observation group were treated with pylorus-preserving pancreaticoduodenectomy(PPPD).Patients in the control group were treated with standard pancreaticoduodenectomy(SPD).The general clinical data,intraoperative and postoperative indicators(intraoperative blood loss,duration of operation,gastric tube indwelling time and length of hospital stay)were compared between the two groups of patients,and the incidence rate of postoperative complications(delayed gastric emptying,intra-abdominal infection,biliary fistula and pancreatic fistula)was investigated.Results There was no statistically significant difference between the two groups in age,gender,history of abdominal surgery,body mass index,total bilirubin,hemoglobin,and albumin(P>0.05);there was no statistically significant difference between the two groups in the indwelling time of the gastric tube and the length of hospital stay(P>0.05);the duration of operation in the observation group was significantly shorter than that in the control group,and the intraoperative blood loss was significantly lower than that in the control group.The differences were statistically significant(P<0.05);the total incidence rate of postoperative complications in the observation group was of 3 cases(10.71%),and the total incidence rate of postoperative complications in the control group was of 4 cases(14.28%),the differences were not statistically significant(P>0.05).Conclusion Compared with the standard pancreaticoduodenectomy,the pylorus-preserving pancreaticoduodenectomy has a shorter duration of operation and less intraoperative blood loss

关 键 词：胰头导管癌 保留幽门胰十二指肠切除术 标准胰十二指肠切除术 临床效果 

分 类 号：R735.9[医药卫生—肿瘤]