Kozlov I A, Korniak B S, Skuba N D, Shevchenko T V, Alikhanov R B
Khirurgiia (Mosk). 2003(8):11-8.
Results of two surgeries--total and subtotal resection of pancreatic head in combination with selective proximal vagotomy (SPV)--performed for chronic pancreatitis and duodenal ulcer disease (DUD) are presented. In one case surgery was supplemented with circular resection of the duodenum and fundoplication. Reconstructive stage of both surgeries included creation of pacreato- and biliodigestive anastomosis on Roux intestinal loop. Choledochojejunoanastomosis was created on the same loop of the small intestine either "end-to-side" with supraduodenal part of common bile duct or "side-to-side" with its pancreatic part. The former surgery was finished with duodenoduodenoanastomosis "end-to-end" for recovery of duodenal passage. This surgery was characterized by complete removal of pancreatic head. The latter surgery corresponded to Beger's operation. There were no complications in the nearest postoperative period. Long-term results were favorable and followed up during 17.5 and 7 months, respectively. This experience testifies that resection of pancreatic head with SPV may be considered as alternative to pancreatoduodenal resection in surgical treatment of patients with chronic pancreatitis.
本文介绍了针对慢性胰腺炎和十二指肠溃疡疾病（DUD）实施的两种手术——胰头全切除及次全切除联合选择性近端迷走神经切断术（SPV）——的结果。其中1例手术辅以十二指肠环形切除及胃底折叠术。两种手术的重建阶段均包括在Roux肠袢上建立胰-胆消化道吻合。胆总管空肠吻合在小肠的同一肠袢上进行，与胆总管十二指肠上段“端对侧”吻合或与其胰腺段“侧对侧”吻合。前一种手术以十二指肠端端吻合完成十二指肠通路的恢复。该手术的特点是胰头完全切除。后一种手术相当于Beger手术。术后近期无并发症。长期结果良好，分别随访了17.5个月和7个月。这一经验证明，在慢性胰腺炎患者的手术治疗中，胰头切除联合SPV可被视为胰十二指肠切除术的替代方案。
