保留幽门的胰十二指肠切除术中的幽门切开术
Pylorotomy in pylorus-preserving pancreaticoduodenectomy.
作者信息
Nakai Takuya, Kawabe Takashi, Shiraishi Osamu, Okuno Kiyotaka, Shiozaki Hitoshi
机构信息
First Department of Surgery, Kinki University School of Medicine, Osaka, Japan.
出版信息
Hepatogastroenterology. 2006 Nov-Dec;53(72):947-9.
BACKGROUND/AIMS: The incidence of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy has been reported to be 30% to 70%.
METHODOLOGY
Between January 1996 and December 2002, 43 patients underwent pylorus-preserving pancreaticoduodenectomy, involving pylorotomy, in the First Department of Surgery, Kinki University School of Medicine. The first step in pylorotomy is to cut the duodenal stump obliquely. The next is incision of the pyloric sphincter along its inferior aspect. The incidences of postoperative complications and changes in body weight were collated retrospectively.
RESULTS
Delayed gastric emptying was observed in 4 patients (9.3%). However, this complication did not last more than 1 month in any patients. Two patients (4.7%) developed reflux esophagitis 1 month after surgery, but this complication had resolved by 6 months. Weight gain was noted beginning 3 months after surgery.
CONCLUSIONS
Pylorus-preserving pancreaticoduodenectomy involving pylorotomy may reduce the incidence of delayed gastric emptying and preserve the long-term quality of life more than similar procedures.
背景/目的：据报道，保留幽门的胰十二指肠切除术后胃排空延迟的发生率为30%至70%。
方法
1996年1月至2002年12月期间，近畿大学医学院第一外科对43例患者进行了保留幽门的胰十二指肠切除术，其中包括幽门切开术。幽门切开术的第一步是斜行切开十二指肠残端。接下来是沿幽门括约肌下缘切开。回顾性整理术后并发症的发生率和体重变化情况。
结果
4例患者（9.3%）出现胃排空延迟。然而，该并发症在任何患者中持续时间均未超过1个月。2例患者（4.7%）在术后1个月出现反流性食管炎，但该并发症在6个月时已缓解。术后3个月开始出现体重增加。
结论
与类似手术相比，涉及幽门切开术的保留幽门的胰十二指肠切除术可能会降低胃排空延迟的发生率，并更好地维持长期生活质量。
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