Kang Pengcheng, Wang Zhidong, Leng Kaiming, Zhong Xiangyu, Wang Hao, Wan Ming, Tai Sheng, Cui Yunfu
Department of Hepatopancreatobiliary Surgery, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Medicine (Baltimore). 2017 Nov;96(45):e8354. doi: 10.1097/MD.0000000000008354.
A growing number of central pancreatectomies are performed. However, reconstruction of pancreaticoenteral digestive continuity after central pancreatectomy remains debated. This study evaluates the short-term outcomes of binding pancreaticogastrostomy anastomosis in central pancreatectomy.We have reviewed our experience with 52 patients who underwent binding pancreaticogastrostomy following central pancreatectomy from February 2009 to March 2015. Indication includes 6 noninvasive intraductal papillary mucinous neoplasms, 11 neuroendocrine tumors, 12 solid pseudopapillary tumor, 9 serous cystadenoma, 6 mucinous cystadenoma, and 8 focal pancreatic traumas.The mortality rate was nil while the morbidity rate was 34.6%. Eighteen patients experienced complications including 6 pancreatic fistulas, 2 postpancreatectomy hemorrhages, 4 delayed gastric emptying, 1 hypostatic pneumonia, and 5 pancreatitis. The median postoperative length of hospital stay was 12 days (10 days for patients without fistula). None of the 52 patients were found to have pancreatic endocrine or exocrine insufficiency or recurrence of tumors.Central pancreatectomy with binding pancreaticogastrostomy is a useful and practicable surgical procedure for benign or borderline lesions of the pancreatic neck or proximal body.
中央型胰腺切除术的实施数量日益增多。然而，中央型胰腺切除术后胰肠消化连续性的重建仍存在争议。本研究评估了中央型胰腺切除术中捆绑式胰胃吻合术的短期疗效。我们回顾了2009年2月至2015年3月期间52例行中央型胰腺切除术后接受捆绑式胰胃吻合术患者的经验。适应症包括6例非侵袭性导管内乳头状黏液性肿瘤、11例神经内分泌肿瘤、12例实性假乳头状肿瘤、9例浆液性囊腺瘤、6例黏液性囊腺瘤和8例局限性胰腺创伤。死亡率为零，发病率为34.6%。18例患者出现并发症，包括6例胰瘘、2例胰腺切除术后出血、4例胃排空延迟、1例坠积性肺炎和5例胰腺炎。术后中位住院时间为12天（无瘘患者为10天）。52例患者均未发现胰腺内分泌或外分泌功能不全或肿瘤复发。对于胰腺颈部或近端体部的良性或交界性病变，中央型胰腺切除术联合捆绑式胰胃吻合术是一种有用且可行的手术方法。
