Roder J D, Stein H J, Hüttl W, Siewert J R
Department of Surgery, Technical University, Munich, Germany.
Br J Surg. 1992 Feb;79(2):152-5. doi: 10.1002/bjs.1800790219.
Pylorus-preserving pancreaticoduodenectomy (PPPD) has received increasing attention as a physiological alternative to the standard pancreaticoduodenectomy (PD) in patients with adenocarcinoma of the pancreatic head or the periampullary region. We evaluated mortality, morbidity and survival in 110 patients with pancreatic carcinoma (n = 53) or periampullary carcinoma (n = 57). In each group 31 patients underwent PD, the remainder PPPD. There were no differences in age, sex and tumour stage (UICC 1987) between patients undergoing PPPD or PD. Median follow-up was 24 months. There were no significant differences in mortality and morbidity rates between procedures. The mode of resection had no influence on survival in patients with periampullary carcinoma. Patients with pancreatic carcinoma who underwent PD had a significantly better survival rate compared with those who underwent PPPD (P less than or equal to 0.05). This was particularly so in patients with stage III tumours (P = 0.007). These data suggest that in patients with ductal carcinoma of the head of the pancreas, PD provides better survival than PPPD. However, PPPD appears to achieve equivalent results to PD in patients with periampullary carcinoma.
保留幽门的胰十二指肠切除术（PPPD）作为胰头或壶腹周围腺癌患者标准胰十二指肠切除术（PD）的一种生理性替代术式，已受到越来越多的关注。我们评估了110例胰腺癌患者（n = 53）或壶腹周围癌患者（n = 57）的死亡率、发病率和生存率。每组中31例患者接受了PD，其余患者接受了PPPD。接受PPPD或PD的患者在年龄、性别和肿瘤分期（UICC 1987）方面无差异。中位随访时间为24个月。两种手术方式在死亡率和发病率方面无显著差异。手术切除方式对壶腹周围癌患者的生存率无影响。与接受PPPD的患者相比，接受PD的胰腺癌患者生存率显著更高（P≤0.05）。在Ⅲ期肿瘤患者中尤其如此（P = 0.007）。这些数据表明，对于胰头导管癌患者，PD比PPPD提供更好的生存率。然而，对于壶腹周围癌患者，PPPD似乎能取得与PD相当的结果。
