Pakosz-Golanowska Monika, Post Mariola, Lubikowski Jerzy, Butkiewicz Jacek, Białek Andrzej, Raszeja-Wyszomirska Joanna, Wiechowska-Kozłowska Anna, Milkiewicz Piotr, Wójcicki Maciej
Division of Hepatobiliary Surgery and Liver Transplantation, Marie Curie Hospital, Szczecin, Poland.
Hepatogastroenterology. 2009 Sep-Oct;56(94-95):1533-7.
BACKGROUND/AIMS: Obstruction of the main pancreatic duct in chronic pancreatitis (CP) leads to an increased intraductal and intraparenchymal pressure causing pain. In this study we evaluated the outcome of surgical treatment of CP including the quality of life following Partington-Rochellepancreaticojejunostomy (PRP) performed for intractable pain.
Between July 2002 and May 2008, PRP was performed in 17 patients in whom the diameter of the main pancreatic duct exceeded 7mm and there was no inflammatory tumor in the pancreatic head. Perioperative morbidity and mortality were analyzed in all patients. The long term outcome including the quality of life (Karnofsky index) was evaluated in 9 patients who were followed with a mean 28 (range 13-60) months since surgery.
Complications in the postoperative period were found in 3 (18%) patients including 1 death due to a myocardial infarction shortly after surgery. All patients submitted to the long-term evaluation reported a significant (p < 0.0001) pain reduction by an average of 6.2 (5-8) points in a 10-points visual analogue scale. The Karnofsky index increased significantly from a mean 52% (40-70%) before surgery up to 82% (70-90%) following surgery and long-term.
PRP leads to a substantial quality of life improvement in patients with CP.
背景/目的：慢性胰腺炎（CP）中主胰管梗阻导致管内和实质内压力升高，引起疼痛。在本研究中，我们评估了CP的手术治疗结果，包括针对顽固性疼痛进行Partington-Rochelle胰空肠吻合术（PRP）后的生活质量。
2002年7月至2008年5月期间，对17例主胰管直径超过7mm且胰头无炎性肿瘤的患者进行了PRP。分析了所有患者的围手术期发病率和死亡率。对9例患者进行了长期随访，平均随访时间为术后28（13 - 60）个月，评估了包括生活质量（卡诺夫斯基指数）在内的长期结果。
术后有3例（18%）患者出现并发症，其中1例在术后不久因心肌梗死死亡。所有接受长期评估的患者在10分视觉模拟量表上均报告疼痛显著减轻（p < 0.0001），平均减轻6.2（5 - 8）分。卡诺夫斯基指数从术前平均52%（40 - 70%）显著提高到术后及长期的82%（70 - 90%）。
PRP可显著改善CP患者的生活质量。
