Potts J R, Vogt D P, Broughan T, Hermann R E
Department of General Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309.
Am Surg. 1991 Jan;57(1):24-8.
This review was undertaken to determine whether there are specific factors which predict the development of gastric outlet obstruction (GOO) in patients with pancreatic carcinoma. One hundred forty-two patients with biopsy proven pancreatic carcinoma had palliative operations of whom 74 had gastric bypass (GB). Of the 68 who did not, four died after biliary bypass. The 64 patients who remained at risk for GOO are the subject of this report. Seven of those patients developed GOO in the postoperative period and were compared with the 57 who did not. No significant difference was found between the two groups when they were compared on the basis of 20 historic, laboratory, and operative finding criteria. These data indicate that accurate prediction of subsequent GOO is not possible based on available objective data. Because GB creation does not increase operative blood loss, operative time, postoperative stay, or postoperative morbidity, and because prediction of need is difficult, prophylactic GB should be applied very liberally.
本综述旨在确定是否存在特定因素可预测胰腺癌患者胃出口梗阻（GOO）的发生。142例经活检证实为胰腺癌的患者接受了姑息性手术，其中74例行胃旁路术（GB）。在未行胃旁路术的68例患者中，4例在胆道旁路术后死亡。本报告的研究对象是其余有发生GOO风险的64例患者。其中7例患者在术后发生了GOO，并与未发生GOO的57例患者进行了比较。根据20项病史、实验室检查和手术发现标准对两组进行比较时，未发现显著差异。这些数据表明，基于现有的客观数据无法准确预测后续的GOO。由于施行胃旁路术不会增加术中失血量、手术时间、术后住院时间或术后发病率，且难以预测是否需要施行该手术，因此预防性胃旁路术的应用应非常宽松。
