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钩突部胰腺炎行胰头钩突切除术:病例报告

Groove resection of pancreatic head in groove pancreatitis: A case report.

作者信息

Zhu Chunfu, Huang Qin, Zhu Jianfei, Zhang Xudong, Qin Xihu

机构信息

Department of Hepato-biliary-pancreatic Surgery, Changzhou No. 2 People's Hospital, Nanjing Medical University, Changzhou, Jiangsu 213000, P.R. China.

Department of Pathology and Laboratory Medicine, Veterans Affairs Boston Healthcare System, Harvard Medical School, West Roxbury, MA 02132, USA.

出版信息

Exp Ther Med. 2017 Sep;14(3):1983-1988. doi: 10.3892/etm.2017.4753. Epub 2017 Jul 10.

Abstract

Groove pancreatitis (GP) is a rare type of chronic pancreatitis, which primarily affects the groove area of the pancreatic head. Surgery is considered as the ultimate method for GP if the symptoms are not improved by conservative or endoscopic treatments, and the Whipple technique is the common choice at present. The present study introduces a novel surgical procedure for GP, namely groove resection of pancreatic head (GRPH), in a 56-year-old male patient. To the best of our knowledge, this is the first report on GRPH for the surgical treatment of GP. This patient was diagnosed with typical GP without any evidence of malignancy, based on imaging studies and gastrointestinal endoscopy, and was treated with GRPH. Briefly, only the groove area of the pancreatic head was resected, while the duodenum, the main pancreatic duct and the majority of the pancreatic head were preserved. A complete relief of abdominal pain and a weight gain were achieved 2 months after surgery. Endoscopic examination indicated marked improvement of the duodenal lesions. In conclusion, GRPH is a less invasive surgical procedure for GP compared with other surgical procedures and may be an alternative for the surgical treatment of GP without severe lesions or stenosis of the duodenum.

摘要

沟部胰腺炎(GP)是一种罕见的慢性胰腺炎类型,主要累及胰头的沟部区域。如果保守治疗或内镜治疗无法改善症状,手术被认为是治疗GP的最终方法,而惠普尔手术是目前常用的选择。本研究介绍了一种针对GP的新型手术方法,即胰头沟部切除术(GRPH),应用于一名56岁男性患者。据我们所知,这是首例关于GRPH用于GP手术治疗的报告。该患者基于影像学检查和胃肠内镜检查被诊断为典型的GP且无任何恶性肿瘤证据,并接受了GRPH治疗。简而言之,仅切除了胰头的沟部区域,而十二指肠、主胰管和大部分胰头得以保留。术后2个月腹痛完全缓解且体重增加。内镜检查显示十二指肠病变明显改善。总之,与其他手术方法相比,GRPH是一种治疗GP的侵入性较小的手术方法,对于无严重病变或十二指肠狭窄的GP手术治疗可能是一种替代方法。

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