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慢性胰腺炎行胰体尾空肠吻合术的短期和长期结果:一项日本单中心回顾性研究

Short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis: a retrospective Japanese single-center study.

作者信息

Sudo Takeshi, Murakami Yoshiaki, Uemura Kenichiro, Hashimoto Yasushi, Kondo Naru, Nakagawa Naoya, Sueda Taijiro

机构信息

Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.

出版信息

J Hepatobiliary Pancreat Sci. 2014 Jun;21(6):426-32. doi: 10.1002/jhbp.48. Epub 2013 Oct 23.

Abstract

BACKGROUND

The study aim was to determine the short- and long-term results of lateral pancreaticojejunostomy for chronic pancreatitis at a single center in Japan.

METHODS

The records of 64 consecutive patients were retrospectively reviewed. All patients underwent surgery at Hiroshima University Hospital between December 1996 and April 2013. Long-term follow-up was performed in 58 patients (91%) for a median period of 34 months.

RESULTS

The 53 men (83%) and 11 women (17%) had a mean age of 55 years. The etiology of pancreatitis was chronic alcohol abuse in 44 patients (69%). The major indication for surgery was acute pancreatitis exacerbation (80%). There was no postoperative mortality. Postoperative morbidity occurred in 21 patients (33%), with severe complications requiring non-surgical intervention in four (6%). The percentage of pain-free patients after surgery was 91%, and further acute exacerbation was prevented in 95%. Four patients (7%) required subsequent surgery for pancreatitis-related complications. Of the patients that completed follow-up, 33 (57%) had diabetes mellitus, including 11 patients (19%) with new-onset diabetes; 30 patients (56%) developed pancreatic exocrine insufficiency.

CONCLUSIONS

Full-length lateral pancreaticojejunostomy is safe, feasible, and effective for managing chronic pancreatitis. The technique prevents further exacerbations and maintains appropriate pancreatic endocrine and exocrine function.

摘要

背景

本研究旨在确定在日本一家单一中心进行的慢性胰腺炎胰体尾侧空肠吻合术的短期和长期结果。

方法

对64例连续患者的记录进行回顾性分析。所有患者均于1996年12月至2013年4月在广岛大学医院接受手术。58例患者(91%)进行了长期随访,中位随访时间为34个月。

结果

53例男性(83%)和11例女性(17%),平均年龄55岁。44例患者(69%)胰腺炎的病因是慢性酒精滥用。手术的主要指征是急性胰腺炎加重(80%)。无术后死亡病例。21例患者(33%)发生术后并发症,4例(6%)出现严重并发症需要非手术干预。术后无痛患者的比例为91%,95%的患者预防了进一步的急性加重。4例患者(7%)因胰腺炎相关并发症需要后续手术。在完成随访的患者中,33例(57%)患有糖尿病,其中11例(19%)为新发糖尿病;30例患者(56%)出现胰腺外分泌功能不全。

结论

全长胰体尾侧空肠吻合术治疗慢性胰腺炎安全、可行且有效。该技术可预防进一步加重,并维持适当的胰腺内分泌和外分泌功能。

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