Lorenz D, Waclawiczek H
Klinik für Chirurgie, Ernst-Moritz-Arndt-Universität Greifswald.
Zentralbl Chir. 1990;115(18):1141-53.
The three original aims of pancreatic duct occlusion (PDO) were first the reduction of early complications after Whipple's operation in chronic pancreatitis and carcinoma as well as segmental pancreas transplantation, second to finish the inflammation in cases of chronic pancreatitis and third to protect the B-cell function in remained or transplanted pancreas. We have compared PDO by Tissucol and Ethibloc with non-occluded pancreases up to 3 years after Whipple's operation in patients with chronic pancreatitis and carcinoma and in patients with autologous segmental pancreas transplantation. In concluding the results one can say that PDO is of high value with regard to early complications in patients with pancreas carcinoma. In these patients and in autologous pancreas transplantation the PDO by Tissucol seems to have more protective effect on B-cell function than the other approaches. In patients with chronic pancreatitis and Whipple's operation the PDO was without value neither for early complications, these are very low anyhow, nor B-cell function.
胰腺导管阻塞(PDO)最初的三个目标,一是减少慢性胰腺炎、胰腺癌以及节段性胰腺移植患者在Whipple手术后的早期并发症;二是消除慢性胰腺炎患者的炎症;三是保护残余或移植胰腺的B细胞功能。我们在慢性胰腺炎、胰腺癌患者以及自体节段性胰腺移植患者中,对比了使用纤维蛋白黏合剂(Tissucol)和乙基纤维素(Ethibloc)进行胰腺导管阻塞与未阻塞胰腺长达3年的情况。总结结果可以说,对于胰腺癌患者的早期并发症而言,胰腺导管阻塞具有很高的价值。在这些患者以及自体胰腺移植中,使用纤维蛋白黏合剂进行胰腺导管阻塞似乎比其他方法对B细胞功能具有更强的保护作用。对于慢性胰腺炎并接受Whipple手术的患者,胰腺导管阻塞对于早期并发症(反正这些并发症非常少)和B细胞功能均无价值。