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保留器官的胰腺切除术治疗良性或低级别潜在恶性病变的临床疗效。

Clinical efficacy of organ-preserving pancreatectomy for benign or low-grade malignant potential lesion.

机构信息

Department of Surgery, Seoul National University, College of Medicine, Seoul, Korea.

出版信息

J Korean Med Sci. 2010 Jan;25(1):97-103. doi: 10.3346/jkms.2010.25.1.97. Epub 2009 Dec 26.

Abstract

The clinical usefulness of organ-preserving pancreatectomy is not well established due to technical difficulty and ambiguity of functional merit. The purpose of this study is to evaluate the clinical efficacy of organ-preserving pancreatectomy such as duodenum-preserving resection of the head of the pancreas (DPRHP), pancreatic head resection with segmental duodenectomy (PHRSD), central pancreatectomy (CP) and spleen-preserving distal pancreatectomy (SPDP). Between 1995 and 2007, the DPRHP were performed in 14 patients, the PHRSD in 16 patients, the CP in 13 patients, and the SPDP in 45 patients for preoperatively diagnosed benign lesions or tumors with low-grade malignant potential. The clinical outcomes including surgical details, postoperative complications and long-term functional outcomes were compared between organ-preserving pancreatectomy and conventional pancreatectomy group. Major postoperative complications constituted the following: bile duct stricture (7.1% [1/14]) in DPRHP, delayed gastric emptying (31.2% [5/16]) in PHRSD, pancreatic fistula (21.4% [3/14]) in CP. There were no significant differences in postoperative complications and long-term functional outcomes between two groups. Organ-preserving pancreatectomy is associated with tolerable postoperative complications, and good long-term outcome comparing to conventional pancreatectomy. Organ-preserving pancreatectomy could be alternative treatment for benign or low-grade malignant potential lesion of the pancreas or ampullary/parapapillary duodenum.

摘要

由于技术难度和功能优势的不确定性,保留器官的胰腺切除术的临床实用性尚未得到充分证实。本研究旨在评估保留器官的胰腺切除术(如保留十二指肠胰头切除术(DPRHP)、胰头切除加节段性十二指肠切除术(PHRSD)、胰中段切除术(CP)和保留脾脏的胰体尾切除术(SPDP))的临床疗效。1995 年至 2007 年间,我们对 14 例术前诊断为良性病变或低度恶性潜能肿瘤的患者施行 DPRHP,对 16 例患者施行 PHRSD,对 13 例患者施行 CP,对 45 例患者施行 SPDP。比较了保留器官的胰腺切除术与常规胰腺切除术组的手术细节、术后并发症和长期功能结果。主要术后并发症包括:DPRHP 中胆管狭窄(7.1%[1/14])、PHRSD 中胃排空延迟(31.2%[5/16])、CP 中胰瘘(21.4%[3/14])。两组间术后并发症和长期功能结果无显著差异。保留器官的胰腺切除术术后并发症可耐受,与常规胰腺切除术相比,长期结果良好。保留器官的胰腺切除术可作为胰腺或壶腹/胰头旁十二指肠良性或低度恶性潜能病变的替代治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a19/2800014/6c90092b11ac/jkms-25-97-g001.jpg

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