Hashimi H
Department of Surgery, Bradford Royal Infirmary, UK.
Int J Pancreatol. 1990 Aug-Nov;7(1-3):55-9.
From a total of 146 patients with carcinoma of the head of the pancreas and preiampullary region, treated surgically, 31 underwent Whipple's pancreaticoduodenectomy. Eighteen were carried out at the initial laparotomy and thirteen at a second-look operation (SLO). Of the 128 patients who underwent bypass as palliative procedure, 36 were selected. All were less than 65 yr of age, and their general condition continued to improve postoperatively. They were reassessed regularly with view to SLO. Whipple's procedure was accomplished in 13 cases. Ten out of 13 patients had a raised serum amylase at the initial exploration, indicating coexisting pancreatitis. SLO should be considered in fit patients with evidence of concomitant acute pancreatitis at the initial laparotomy, since pancreatitis can make some tumors seem locally invasive and hence unresectable at the initial laparotomy.
在146例接受手术治疗的胰头和壶腹周围癌患者中，31例行惠普尔胰十二指肠切除术。18例在初次剖腹手术时进行，13例在二次探查手术（SLO）时进行。在128例接受姑息性旁路手术的患者中，选择了36例。所有患者年龄均小于65岁，术后一般状况持续改善。定期对他们进行重新评估以考虑二次探查手术。13例完成了惠普尔手术。13例患者中有10例在初次探查时血清淀粉酶升高，提示并存胰腺炎。对于初次剖腹手术时有伴发急性胰腺炎证据的合适患者，应考虑二次探查手术，因为胰腺炎可使一些肿瘤在初次剖腹手术时看似局部浸润性，因而无法切除。
