Gall F P, Gebhardt C, Meister R, Zirngibl H, Schneider M U
World J Surg. 1989 Nov-Dec;13(6):809-16; discussion 816-7. doi: 10.1007/BF01658445.
Partial duodenopancreatectomy and occlusion of the remaining ductal system by Ethibloc to induce rapid exocrine atrophy for treatment of severe chronic cephalic pancreatitis was introduced in our department in January of 1978. Since then, this surgical procedure has been performed in a total of 289 patients. Postoperative morbidity was 12.2%, 5 pancreatic and 3 biliary fistulas occurred. Postoperative mortality was 1% and relapses of pancreatitis occurred in only 2.2% due to incomplete filling of ducts with Ethibloc. A total of 88.2% of patients became pain-free and symptomless, 10.8% voiced minor complaints, and 85.9% gained an averaged of 7.8 kg weight postoperatively. We conclude that Ethibloc occlusion is highly effective in inducing complete exocrine atrophy, thus abolishing the inflammatory process and preventing relapses of chronic pancreatitis and preserving the endocrine function from further impairment. This was demonstrated by biochemical assays during a 36-month follow-up in a prospective study in 23 of 289 patients. Our results compare favorably with and are superior to results from any other operative procedure for chronic cephalic pancreatitis. We consider partial duodenopancreatectomy combined with Ethibloc occlusion of the pancreatic duct the procedure of choice in the surgical treatment of severe chronic cephalic pancreatitis.
1978年1月，我们科室引入了部分十二指肠胰腺切除术，并使用Ethibloc封堵剩余的导管系统，以诱导快速外分泌萎缩，用于治疗严重的慢性胰头炎。从那时起，共有289例患者接受了这种手术。术后发病率为12.2%，发生了5例胰瘘和3例胆瘘。术后死亡率为1%，由于Ethibloc未完全填充导管，胰腺炎复发率仅为2.2%。共有88.2%的患者术后无痛且无症状，10.8%的患者有轻微不适，85.9%的患者术后平均体重增加了7.8公斤。我们得出结论，Ethibloc封堵在诱导完全外分泌萎缩方面非常有效，从而消除炎症过程，预防慢性胰腺炎复发，并防止内分泌功能进一步受损。在一项前瞻性研究中，对289例患者中的23例进行了36个月的随访，通过生化检测证实了这一点。我们的结果与慢性胰头炎的任何其他手术方法相比都更有利，且更优越。我们认为，部分十二指肠胰腺切除术联合Ethibloc封堵胰管是严重慢性胰头炎外科治疗的首选方法。
