Müller M W, Assfalg V, Michalski C W, Büchler P, Kleeff J, Friess H
Chirurgische Klinik und Poliklinik, Technische Universität München, Klinikum rechts der Isar, Ismaningerstrasse 22, 81675, München, Deutschland.
Chirurg. 2009 Jan;80(1):14-21. doi: 10.1007/s00104-008-1576-9.
Benign and low malignant tumors of the middle pancreatic segment can be resected by extended pancreaticoduodenectomy or distal pancreatic resection. Both procedures involve unavoidably extensive loss of normal pancreatic parenchyma, leading to deteriorated endocrine and exocrine pancreatic function. Segmental pancreatic resection represents an organ-preserving surgical procedure. Normal pancreatic tissue can be preserved as only the tumor with a pancreatic segment is resected. Several reports confirm lower mortality and minimal risk of postoperative endocrine or exocrine insufficiency than with standard pancreatic resections. The indication should be limited exclusively to benign or low malignant pancreatic tumors, metastases from other tumors, and focal chronic pancreatitis, as this type of resection cannot be deemed oncologic. Segmental pancreatic resections are technically more demanding and therefore should be performed in experienced centers.
胰腺中段的良性和低恶性肿瘤可通过扩大胰十二指肠切除术或远端胰腺切除术进行切除。这两种手术都不可避免地会导致大量正常胰腺实质的损失,从而导致胰腺内分泌和外分泌功能恶化。节段性胰腺切除术是一种保留器官的外科手术。由于仅切除包含肿瘤的胰腺节段,因此可以保留正常胰腺组织。一些报告证实,与标准胰腺切除术相比,其死亡率更低,术后内分泌或外分泌功能不全的风险最小。该手术的适应症应仅限于良性或低恶性胰腺肿瘤、其他肿瘤的转移灶以及局灶性慢性胰腺炎,因为这种类型的切除术不能被视为肿瘤学上的标准手术。节段性胰腺切除术在技术上要求更高,因此应在经验丰富的中心进行。