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胰腺冷冻手术安全性的实验研究:两种不同冷冻手术技术的比较。

Experimental study of the safety of pancreas cryosurgery: the comparison of 2 different techniques of cryosurgery.

机构信息

Research Unit of Hepato-bilio-pancreatology, Huaxi Hospital, Medical Center, Sichuan University, Chengdu, China.

出版信息

Pancreas. 2010 Jan;39(1):92-6. doi: 10.1097/MPA.0b013e3181bdd41a.

Abstract

OBJECTIVES

To test the feasibility of cryosurgery for pancreatic carcinoma and to observe the consequence of cryosurgery by 2 different techniques.

METHODS

Twelve healthy pigs underwent laparotomy, during which, chop amputation of common bile duct and duodenum were performed, meanwhile other intra-abdominal organs with the pancreas were isolated. Two different techniques of cryosurgery were performed on the pancreas. Group A (n = 6) accepted the mild hypothermic cryosurgery with liquid nitrogen superficial refrigeration, and group B (n = 6) were performed with the deep hypothermic cryosurgery at -170 degrees C with LCS2000 cryogenic surgical system. All the animals' digestive tract was reconstructed with cholecystojejunostomy and gastroenterostomy, respectively.

RESULTS

Acute necrotizing pancreatitis occurred on all animals in group A, of which 5 of the 6 died within 1 week, whereas only 1 of the 6 reported a 4-week survival. All animals in group B survived during the observation, in which only a transient increment and a gradual correction of pancreatic amylase level were recorded. Small pancreatic pseudocyst occurred in 1 case.

CONCLUSIONS

Mild hypothermic cryosurgery with liquid nitrogen superficial refrigeration might lead to pancreatic injury and induce acute pancreatitis, yet deep hypothermic cryosurgery with adequate time showed a promising effect in destroying pancreatic tissue and preventing acute pancreatitis.

摘要

目的

测试冷冻手术治疗胰腺癌的可行性,并观察两种不同技术冷冻手术的结果。

方法

12 头健康猪接受剖腹手术,术中进行胆总管和十二指肠横断,同时分离其他腹腔内脏器和胰腺。对胰腺进行两种不同的冷冻手术技术。A 组(n=6)接受液氮表面制冷的轻度低温冷冻手术,B 组(n=6)接受 LCS2000 低温外科系统的-170°C 深度低温冷冻手术。所有动物的消化道均分别采用胆囊空肠吻合术和胃空肠吻合术重建。

结果

A 组所有动物均发生急性坏死性胰腺炎,其中 6 例中的 5 例在 1 周内死亡,而 6 例中仅 1 例存活 4 周。B 组所有动物在观察期间均存活,仅记录到胰淀粉酶水平短暂升高和逐渐恢复正常。1 例发生小胰腺假性囊肿。

结论

液氮表面制冷的轻度低温冷冻手术可能导致胰腺损伤并引发急性胰腺炎,而适当时间的深度低温冷冻手术在破坏胰腺组织和预防急性胰腺炎方面显示出良好的效果。

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