Shimura Tatsuo, Morinaga Nobuhiro, Suzuki Hideki, Araki Kenichiro, Kobayashi Tsutomu, Koyama Yoshihisa, Yashima Rei, Shibata Masahiko, Takenoshita Seiichi, Kuwano Hiroyuki
Department of General Surgical Science, Gunma University Graduate School of Medicine, Japan.
Hepatogastroenterology. 2012 May;59(115):903-6. doi: 10.5754/hge10735.
BACKGROUND/AIMS: The aim of this paper is to examine the safety and feasibility of pylorus-preserving pancreaticoduodenectomy in elderly patients.
The study population consisted of 40 consecutive patients. They were divided into two groups: Group A (<75 years old) and Group B (=75 years old). Reconstruction with a vertical duodenojejunostomy and internal pancreatic drainage with an omental wrapping was performed on the patients in both the groups.
Less time was required to complete the operations in Group B (280±20min) than in Group A (386±88min; p=0.0006). Intraoperative blood loss in Group B was significantly lesser (365±109g) than that in Group A (629±249g; p=0.0026). No statistically significant difference was observed between both groups, in terms of the length of time required until food intake resumed and length of hospital stay. Although the rate of postoperative complication was higher in Group B (10.0%), no statistically significant difference was observed.
Pylorus-preserving pancreaticoduodenectomy with a vertical duodenojejunostomy and internal pancreatic drainage with an omental wrapping seems safe and can be performed on elderly patients without a significant risk of complications.
背景/目的：本文旨在探讨保留幽门胰十二指肠切除术在老年患者中的安全性和可行性。
研究对象为40例连续患者。他们被分为两组：A组（年龄<75岁）和B组（年龄=75岁）。两组患者均采用垂直十二指肠空肠吻合术重建消化道，并采用网膜包裹进行胰管内引流。
B组完成手术所需时间（280±20分钟）比A组（386±88分钟；p=0.0006）少。B组术中失血量（365±109克）明显少于A组（629±249克；p=0.0026）。两组在恢复进食所需时间和住院时间方面，未观察到统计学上的显著差异。虽然B组术后并发症发生率较高（10.0%），但未观察到统计学上的显著差异。
采用垂直十二指肠空肠吻合术和网膜包裹胰管内引流的保留幽门胰十二指肠切除术似乎是安全的，可用于老年患者，且并发症风险不高。
