Shimada Kazuaki, Sano Tsuyoshi, Sakamoto Yoshihiro, Kosuge Tomoo
Department of Hepatobiliary Pancreatic Surgery Division, National Cancer Center Hospital, Tokyo, Japan.
Hepatogastroenterology. 2005 Nov-Dec;52(66):1874-7.
BACKGROUND/AIMS: Occlusion of the pancreatic duct system has been used to prevent pancreatic leakage by abolishing pancreatic exocrine secretion in pancreatic surgery. However, ductal occlusion has not proved satisfactory for preventing pancreatic fistulas in pancreaticoduodenectomy (PD).
Pancreatic duct occlusion with a watertight drainage system around the pancreatic stump was performed following extended PD in 17 patients with (n=12) or without (n=5) a dilated pancreatic duct.
Transient pancreatitis during the early postoperative period occurred in all patients with a nondilated pancreatic duct. No patient developed pancreatic fistula or any other serious complication in both groups.
Pancreatic duct occlusion may minimize the risk of pancreatic leakage in patients with a nondilated pancreatic duct and a normal pancreas as well as in those with a dilated, obstructed pancreatic duct without compromising the postoperative quality of life. This is a safe and reliable technique for managing the pancreatic remnant in patients undergoing extended PD for advanced pancreaticobiliary malignancy.
背景/目的：在胰腺手术中，通过消除胰腺外分泌来阻塞胰腺导管系统已被用于预防胰瘘。然而，在胰十二指肠切除术（PD）中，导管阻塞对于预防胰瘘尚未证明令人满意。
在17例有（n = 12）或无（n = 5）扩张胰管的患者中，在扩大的PD术后，采用围绕胰腺残端的防水引流系统进行胰管阻塞。
所有胰管未扩张的患者在术后早期均发生短暂性胰腺炎。两组均无患者发生胰瘘或任何其他严重并发症。
胰管阻塞可将胰管未扩张且胰腺正常的患者以及胰管扩张、阻塞的患者发生胰瘘的风险降至最低，且不影响术后生活质量。对于因晚期胰胆恶性肿瘤接受扩大PD的患者，这是一种安全可靠的处理胰腺残端的技术。
