在保留幽门的胰十二指肠切除术并进行胰胃吻合术后，胰腺纤维化与胃排空延迟相关。
Pancreatic fibrosis correlates with delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy with pancreaticogastrostomy.
作者信息
Murakami Hiroya, Suzuki Harumi, Nakamura Takaaki
机构信息
Department of Surgery, Kainan Hospital, Aichi, Japan.
出版信息
Ann Surg. 2002 Feb;235(2):240-5. doi: 10.1097/00000658-200202000-00012.
OBJECTIVE
To show that residual pancreatitis delays gastric emptying, the authors used surgical specimens and studied gastric stasis after pylorus-preserving pancreaticoduodenectomy (PPPD).
SUMMARY BACKGROUND DATA
Delayed gastric emptying is a leading cause of complications after PPPD, occurring in 30% of patients. The pathogenesis of delayed gastric emptying remains unclear.
METHODS
Surgical specimens of the pancreas from 25 patients undergoing PPPD and pancreaticogastrostomy were collected and examined by microscopy according to progressive pancreatic fibrosis and divided into three groups: no fibrosis, periductal fibrosis, and intralobular fibrosis. The authors then measured gastric output from the nasogastric tube, pancreatic output from the pancreatic tube, and the time until patients tolerated a solid diet.
RESULTS
Pancreatic juice output was significantly related to the degree of pathologic findings, and gastric output was inversely related to them. A significant prolongation of postoperative solid diet tolerance correlated with increased pancreatic fibrosis and gastric fluid production.
CONCLUSIONS
Pancreatic fibrosis and increased gastric fluid production correlate with delayed gastric emptying after PPPD with pancreaticogastrostomy.
目的
为了证明残留胰腺炎会延迟胃排空，作者使用手术标本并研究了保留幽门的胰十二指肠切除术（PPPD）后的胃潴留情况。
总结背景数据
胃排空延迟是PPPD术后并发症的主要原因，发生率为30%。胃排空延迟的发病机制尚不清楚。
方法
收集25例行PPPD和胰胃吻合术患者的胰腺手术标本，根据胰腺纤维化进展情况进行显微镜检查，并分为三组：无纤维化、导管周围纤维化和小叶内纤维化。然后作者测量了鼻胃管的胃输出量、胰管的胰液输出量以及患者耐受固体饮食的时间。
结果
胰液输出量与病理结果程度显著相关，而胃输出量与之呈负相关。术后固体饮食耐受时间的显著延长与胰腺纤维化增加和胃液分泌增多相关。
结论
PPPD联合胰胃吻合术后，胰腺纤维化和胃液分泌增多与胃排空延迟相关。
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