Grace P A, Pitt H A, Longmire W P
Department of Surgery, Royal College of Surgeons, Ireland, Dublin.
Br J Surg. 1990 Sep;77(9):968-74. doi: 10.1002/bjs.1800770906.
Pylorus preserving pancreatoduodenectomy (PPPD) was reintroduced 12 years ago. Since that time, over 400 patients have undergone PPPD with approximately 41 per cent having chronic pancreatitis and 54 per cent having pancreatic and other periampullary malignancies. Reported 5-year survivals in this latter group have been comparable to those achieved by the classic Whipple procedure. The postoperative mortality rate in 339 reported patients has been 3.8 per cent. Postoperative morbidity, including delayed gastric emptying, has been similar to that of the classic Whipple operation. However, PPPD has been associated with fewer late problems with dumping, diarrhoea, delayed gastric emptying (8.6 per cent), and marginal ulceration (3.6 per cent). Moreover, most patients undergoing PPPD have been able to return to their preoperative and preillness weight. The additional advantage of decreased operative time makes PPPD an attractive alternative to the classic pancreatoduodenectomy.
保留幽门的胰十二指肠切除术（PPPD）于12年前重新被采用。自那时以来，已有400多名患者接受了PPPD，其中约41%患有慢性胰腺炎，54%患有胰腺及其他壶腹周围恶性肿瘤。据报道，后一组患者的5年生存率与经典的惠普尔手术相当。在339例报告患者中，术后死亡率为3.8%。术后并发症，包括胃排空延迟，与经典的惠普尔手术相似。然而，PPPD与倾倒、腹泻、胃排空延迟（8.6%）和边缘溃疡（3.6%）等较少的晚期问题相关。此外，大多数接受PPPD的患者能够恢复到术前和患病前的体重。手术时间缩短这一额外优势使PPPD成为经典胰十二指肠切除术的一个有吸引力的替代方案。
