Pliam M B, ReMine W H
Arch Surg. 1975 May;110(5):506-12. doi: 10.1001/archsurg.1975.01360110052010.
The results of 64 total pancreatectomies performed at the Mayo Clinic between 1942 and 1973 have been reviewed. Improvement in recent results as compared to the previously reported series is probably related to improvements in operative techniques and in selection of patients with more favorable malignant lesions. The recent results are more favorable than those reported for a group of comparable patients undergoing standard Whipple procedures for malignant lesions at this institution. Diabetes was easily managed in 76% of patients. Hypoglycemia due to insulin sensitivity is the major problem, and ketoacidosis seldom occurs. Recognition of this has resulted in better management of diabetes with relatively small doses of insulin. The sequels of long-standing diabetes do not appear to be a problem. Gastrointestinal tract hemorrhage has been greatly decreased through the use of more extensive gastric resection.
对1942年至1973年间在梅奥诊所进行的64例全胰切除术的结果进行了回顾。与先前报道的系列相比，近期结果的改善可能与手术技术的改进以及对具有更有利恶性病变的患者的选择有关。近期结果比在该机构接受标准惠普尔手术治疗恶性病变的一组可比患者所报道的结果更有利。76%的患者糖尿病易于控制。胰岛素敏感性导致的低血糖是主要问题，酮症酸中毒很少发生。认识到这一点后，使用相对小剂量的胰岛素就能更好地控制糖尿病。长期糖尿病的后遗症似乎不是问题。通过更广泛的胃切除术，胃肠道出血已大大减少。
