Halloran C M, Ghaneh P, Bosonnet L, Hartley M N, Sutton R, Neoptolemos J P
Department of Surgery, Royal Liverpool University Hospital, UK.
Dig Surg. 2002;19(2):138-46. doi: 10.1159/000052029.
Pancreatic cancer is a common cause of cancer death in the developed world. Currently, resection is the only chance of long-term survival. The post-operative mortality in nonspecialist centres often exceeds 20% but is around 6% or less in specialist centres. The overall complication rate even in specialist centres is 18-54%. An analysis of eleven large series of pancreatic resections shows an incidence of common complications of 10.4% for fistula, 9.9% for delayed gastric emptying, 4.8% for bleeding, 4.8% for wound infection and 3.8% for intra-abdominal abscess. The median hospital stay is 13-18 days in different series. The re-operation rate varies from 4 to 9% with a mortality rate of 23 to 67%. Major complications are a significant factor in post-operative mortality, especially if they require re-operation. The use of octreotide or somatostatin to prevent complications is supported by several multicentre, double-blind, randomized controlled trials. The best way to improve outcome is to concentrate pancreatic cancer care in regional specialist centres.
在发达国家，胰腺癌是癌症死亡的常见原因。目前，手术切除是获得长期生存的唯一机会。非专科中心的术后死亡率往往超过20%，但在专科中心约为6%或更低。即使在专科中心，总体并发症发生率也为18 - 54%。对11个大型胰腺癌切除系列的分析显示，常见并发症的发生率为：胰瘘10.4%、胃排空延迟9.9%、出血4.8%、伤口感染4.8%、腹腔内脓肿3.8%。不同系列中，中位住院时间为13 - 18天。再次手术率为4%至9%，死亡率为23%至67%。主要并发症是术后死亡的一个重要因素，尤其是那些需要再次手术的并发症。多项多中心、双盲、随机对照试验支持使用奥曲肽或生长抑素预防并发症。改善治疗效果的最佳方法是将胰腺癌护理集中在地区专科中心。
