Monaco A, Daboval A, Armellino M, D'Agostino A, Belli G
Chirurgia Generale e Trapianti d'Organo, II Facoltà di Medicina e Chirurgia, Università degli Studi di Napoli.
Minerva Chir. 1990 Jun 15;45(11):809-12.
The surgical treatment of pancreatic carcinoma is palliative in 90% of cases. The authors report their experience with 25 patients with unresectable pancreatic exocrine cancer, 23 of whom underwent palliative surgery. Sixteen patients had a bilioenteric by-pass and in 7 cases a gastroenterostomy was associated. The postoperative mortality rate was 8.7% and morbidity 28.6%. Eight patients with bilioenteric bypass only survived and only two of these required gastroenterostomy later on because of neoplastic duodenal obstruction. The shorter hospital stay and the longer survival of patients treated by bilioenteric by-pass only suggest that prophylactic gastroenterostomy is unnecessary and should be associated in selected patients only.
90%的胰腺癌手术治疗属于姑息性治疗。作者报告了他们对25例无法切除的胰腺外分泌癌患者的治疗经验，其中23例接受了姑息性手术。16例患者进行了胆肠吻合术，7例同时进行了胃肠吻合术。术后死亡率为8.7%，发病率为28.6%。仅接受胆肠吻合术的8例患者存活，其中只有2例后来因肿瘤性十二指肠梗阻需要进行胃肠吻合术。仅接受胆肠吻合术治疗的患者住院时间较短且生存期较长，这表明预防性胃肠吻合术没有必要，仅应在选定的患者中进行。
