Fisher Jason C, Kuenzler Keith A, Bodenstein Lawrence, Chabot John A
Division of Pediatric Surgery, Morgan Stanley Children's Hospital of New York-Presbyterian, Columbia University Medical Center, New York, NY 10032, USA.
J Pediatr Surg. 2007 Apr;42(4):740-6. doi: 10.1016/j.jpedsurg.2006.12.023.
Children requiring surgical intervention for pancreatic disease may be at risk long term for exocrine insufficiency and glucose intolerance. Pediatric surgeons must balance the need to perform adequate surgical resection while preserving as much normal pancreatic parenchyma as possible. Neoplasms of the middle pancreatic segment with low malignant potential and isolated trauma to the pancreatic body or neck represent 2 conditions where extensive pancreatic resection is unnecessary. Central pancreatectomy for such lesions is well described in adults. Reconstruction of the distal pancreatic remnant is traditionally performed via Roux-en-Y pancreaticojejunostomy. Pancreaticogastrostomy is an alternative approach that has been used to reconstruct the distal pancreas in the adults. Pancreaticogastrostomy offers several technical advantages over pancreaticojejunostomy. Because children may be uniquely susceptible to the long-term consequences of excessive pancreatic resection, 2 cases using this technique of central pancreatectomy with pancreaticogastrostomy are described.
因胰腺疾病需要接受手术干预的儿童，长期来看可能面临外分泌功能不全和葡萄糖耐量异常的风险。小儿外科医生必须在进行充分手术切除的需求与尽可能保留更多正常胰腺实质之间取得平衡。具有低恶性潜能的胰腺中段肿瘤以及胰腺体部或颈部的孤立性创伤是两种无需进行广泛胰腺切除的情况。此类病变的中央胰腺切除术在成人中已有详细描述。传统上，远端胰腺残端的重建是通过 Roux-en-Y 胰空肠吻合术进行的。胰胃吻合术是一种替代方法，已用于成人远端胰腺的重建。与胰空肠吻合术相比，胰胃吻合术具有若干技术优势。由于儿童可能对过度胰腺切除的长期后果特别敏感，本文描述了 2 例采用中央胰腺切除术联合胰胃吻合术的病例。
