胰头大小作为疼痛性慢性胰腺炎Beger手术预后的一个因素
Size of the pancreatic head as a prognostic factor for the outcome of Beger's procedure for painful chronic pancreatitis.
作者信息
Keus E, van Laarhoven C J H M, Eddes E H, Masclee A A M, Schipper M E I, Gooszen H G
机构信息
Department of Surgery, St Elisabeth Hospital, Tilburg, The Netherlands.
出版信息
Br J Surg. 2003 Mar;90(3):320-4. doi: 10.1002/bjs.4043.
BACKGROUND
Duodenum-preserving resection of the head of the pancreas (DPRHP) according to Beger has been developed as an alternative to pylorus-preserving resection of the pancreatic head for painful chronic pancreatitis.
METHODS
Between 1988 and 2000, 36 consecutive DPRHPs were performed. The group was divided into patients with (group 1; n = 23) and without (group 2; n = 13) significant enlargement of the pancreatic head. Pain was the indication for surgery in all patients.
RESULTS
Complications occurred in 12 patients, necessitating reoperation in 11. Initial overall results were favourable; significant improvement or complete relief of pain was reported in 27 of 35 patients. Long-term results were obtained in 27 of 30 patients; the overall success rate was 16 of 27, 13 of 16 patients with distinct enlargement of the pancreatic head and 3 of the 11 with minimal or no enlargement (P = 0.018).
CONCLUSION
DPRHP can be performed with good early results. This effect is sustained in patients with distinct localized disease of the pancreatic head. In those without, the long-term results are disappointing.
背景
根据贝格尔术式进行的保留十二指肠的胰头切除术（DPRHP）已被开发出来，作为保留幽门的胰头切除术治疗疼痛性慢性胰腺炎的替代方法。
方法
1988年至2000年期间，连续进行了36例DPRHP手术。该组患者分为胰头显著肿大的患者（第1组；n = 23）和胰头无显著肿大的患者（第2组；n = 13）。所有患者的手术指征均为疼痛。
结果
12例患者出现并发症，其中11例需要再次手术。初期总体结果良好；35例患者中有27例报告疼痛显著改善或完全缓解。30例患者中27例获得了长期结果；总体成功率为27例中的16例，胰头明显肿大的16例患者中有13例，胰头轻度肿大或无肿大的11例患者中有3例（P = 0.018）。
结论
DPRHP手术早期效果良好。这种效果在胰头有明显局限性病变的患者中得以维持。在没有这种病变的患者中，长期结果令人失望。
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