针对不可切除胰头癌的改良迪瓦恩切除术式

Modified Devine exclusion for unresectable pancreatic head carcinoma.

作者信息

Kato K, Morita T, Miyasaka Y, Fujita M, Kondo S, Katoh H

机构信息

Department of Surgery, Hokkaido Gastroenterological Hospital, Honcho 1-1, Higashiku, Sapporo, 065-0041, Japan.

出版信息

Hepatogastroenterology. 2001 Mar-Apr;48(38):569-71.

PMID:11379355

Abstract

BACKGROUND/AIMS: Gastrojejunostomy is generally performed for unresectable pancreatic head carcinoma. However, in the case of conventional gastrojejunostomy, the bypass does not always function effectively.

METHODOLOGY

For unresectable pancreatic head carcinoma accompanied by severe duodenal stenosis, conventional gastrojejunostomy was performed in 5 cases, and modified Devine exclusion was performed in 7 cases. There were no significant differences between the groups regarding their backgrounds.

RESULTS

There were no significant differences between the two groups for the average operation time, the days before peroral ingestion and the hospital stay. The state of peroral ingestion showed better results for modified Devine exclusion. The discharge rates were better for modified Devine exclusion, showing a significant difference (P = 0.028). The 50%-survival periods were 65 days and 159 days, respectively. The bleeding from the tumor occurred in 2 patients from the conventional gastrojejunostomy group, but none in modified Devine exclusion group.

CONCLUSIONS

Modified Devine exclusion is a simple and effective technique for unresectable pancreatic head carcinoma.

摘要

背景/目的：胃空肠吻合术通常用于无法切除的胰头癌。然而，在传统胃空肠吻合术的情况下，旁路并不总是能有效发挥作用。

方法

对于伴有严重十二指肠狭窄的无法切除的胰头癌，5例行传统胃空肠吻合术，7例行改良Devine旷置术。两组患者的背景无显著差异。

结果

两组在平均手术时间、经口进食前天数和住院时间方面无显著差异。改良Devine旷置术的经口进食状态显示出更好的结果。改良Devine旷置术的出院率更高，差异有统计学意义（P = 0.028）。50%生存期分别为65天和159天。传统胃空肠吻合术组有2例发生肿瘤出血，而改良Devine旷置术组无出血病例。