Department of Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, 514-8507, Japan.
J Hepatobiliary Pancreat Sci. 2010 Nov;17(6):763-9. doi: 10.1007/s00534-009-0181-8. Epub 2009 Sep 25.
For the surgical management of chronic pancreatitis with an inflammatory pancreatic head mass, extended drainage operations such as Beger and Frey procedures were established in the 1980s as an alternative to resectional procedures like pancreaticoduodenectomy and as opposed to simple drainage operations such as lateral pancreaticojejunostomy, that is, the Partington procedure. With the relatively rapid adoption of the two procedures, it seems that the Partington procedure has become a thing of the past.
The Partington procedure was re-evaluated with regard to the historical aspects and its present status by a literature review.
The results show that this procedure relieves chronic abdominal pain in 66-91% of patients with a mean follow-up of 3.5-9.1 years. It is important to note that this procedure is generally used for inflammatory disease left of the gastroduodenal artery and is specifically not used as the procedure of choice for inflammatory disease of the pancreatic head.
For patients with a dilated main pancreatic duct but without an inflammatory pancreatic head mass, the Partington procedure is still the procedure of choice, since it is technically simple to perform with a minimum of morbidity and mortality, preserving pancreatic endocrine and exocrine function. Because it is a relatively simple technique, the laparoscopic approach will be justified as a treatment of appropriate patients in the near future.
对于伴有炎性胰头部肿块的慢性胰腺炎的外科治疗,扩展引流手术(如 Beger 和 Frey 手术)于 20 世纪 80 年代作为胰十二指肠切除术等切除术的替代方法而建立,并与单纯引流手术(如胰管空肠吻合术,即 Partington 手术)相反。随着这两种手术的相对快速采用,似乎 Partington 手术已经成为过去。
通过文献回顾,重新评估了 Partington 手术的历史方面及其现状。
结果表明,该手术在 3.5-9.1 年的平均随访中,缓解了 66-91%慢性腹痛患者的疼痛。需要注意的是,该手术通常用于胃十二指肠动脉左侧的炎性疾病,并且不作为胰头部炎性疾病的首选手术。
对于胰管扩张但无炎性胰头部肿块的患者,Partington 手术仍然是首选手术,因为它具有技术简单、发病率和死亡率低、保留胰腺内分泌和外分泌功能的优点。由于它是一种相对简单的技术,腹腔镜方法将在不久的将来被证明是治疗合适患者的合理方法。