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保留部分胃的胰十二指肠切除术(SSPPD)与保留幽门的胰十二指肠切除术(PPPD)的手术步骤及临床结果比较

The surgical procedure and clinical results of subtotal stomach preserving pancreaticoduodenectomy (SSPPD) in comparison with pylorus preserving pancreaticoduodenectomy (PPPD).

作者信息

Hayashibe Akira, Kameyama Masao, Shinbo Masaya, Makimoto Shinichiro

机构信息

Department of Surgery, Bell Land General Hospital, 500-8 Higashiyama, Sakai-city, Osaka 599-8247, Japan.

出版信息

J Surg Oncol. 2007 Feb 1;95(2):106-9. doi: 10.1002/jso.20608.

Abstract

BACKGROUND

Subtotal stomach preserving pancreaticoduodenectomy (SSPPD) is compared retrospectively with pylorus preserving pancreaticoduodenectomy (PPPD).

METHODS

During 2002-2005, 21 patients (13 female, 8 male) underwent SSPPD. The mean age was 64.3 (range 33-80). PPPD was performed for 12 patients after 1999. Days of hospital stay, operation time, operative blood loss, postoperative morbidity and mortality, days of nasogastric intubation, days until liquid diet, delayed gastric emptying, postoperative change of serum Albumin value, were compared between SSPPD and PPPD. Clinical characteristics (age, gender, benign, or malignant condition, presence of preoperative jaundice, preoperative value of serum Albumin) were analyzed in both procedures.

RESULTS

In comparison of clinical characteristics, all factors were similar between PPPD and SSPPD. There were also quite similar results in days of hospital stay, operation time, operative blood loss, postoperative morbidity and mortality. Days of nasogastric intubation, days until liquid diet in PPPD were significantly longer than those in SSPPD and the incidence of delayed gastric emptying in PPPD was significantly higher than that in SSPPD. Finally, PPPD and SSPPD postoperative change of serum Albumin value were statistically similar.

CONCLUSIONS

We consider SSPPD as one of the most favorable procedures in patients who undergo pancreaticoduodenectomy.

摘要

背景

对保留部分胃的胰十二指肠切除术(SSPPD)与保留幽门的胰十二指肠切除术(PPPD)进行回顾性比较。

方法

2002年至2005年期间,21例患者(13例女性,8例男性)接受了SSPPD。平均年龄为64.3岁(范围33 - 80岁)。1999年后对12例患者进行了PPPD。比较了SSPPD和PPPD之间的住院天数、手术时间、术中失血量、术后发病率和死亡率、鼻胃管插管天数、开始流食天数、胃排空延迟情况、术后血清白蛋白值变化。对两种手术的临床特征(年龄、性别、良性或恶性疾病、术前黄疸情况、术前血清白蛋白值)进行了分析。

结果

在临床特征比较中,PPPD和SSPPD的所有因素相似。住院天数、手术时间、术中失血量、术后发病率和死亡率的结果也相当相似。PPPD的鼻胃管插管天数、开始流食天数明显长于SSPPD,且PPPD的胃排空延迟发生率明显高于SSPPD。最后,PPPD和SSPPD术后血清白蛋白值变化在统计学上相似。

结论

我们认为SSPPD是接受胰十二指肠切除术患者最有利的手术方式之一。

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