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胰十二指肠切除术与沟部胰腺炎的治疗结果

Pancreaticoduodenectomy and Outcomes for Groove Pancreatitis.

作者信息

Aguilera Fabiola, Tsamalaidze Levan, Raimondo Massimo, Puri Ruchir, Asbun Horacio J, Stauffer John A

机构信息

Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA.

Tbilisi State Medical University, Tbilisi, Georgia.

出版信息

Dig Surg. 2018;35(6):475-481. doi: 10.1159/000485849. Epub 2018 Jan 18.

Abstract

BACKGROUND/AIMS: The operative management of groove pancreatitis (GP) is still a matter of controversy and pancreaticoduodenectomy (PD) can be a high-risk procedure for patients. The aim of this study was to report our 9-year experience of surgical resection for GP and to review relevant literature.

METHODS

A retrospective review of patients undergoing pancreatectomy for GP from August 1, 2008, through May 31, 2017 was performed. Patients with clinical, radiologic, and final pathologic confirmation of GP were included. Literature on the current understanding of GP was reviewed.

RESULTS

Eight patients from total 449 pancreatectomies met inclusion criteria. Four male and 4 female patients (mean age, 51.9 years; mean body mass index, 25.3) underwent pylorus-preserving pancreatoduodenectomy (3 by laparoscopy and 5 by open approach). Mean (range) operative time and blood loss was 343 (167-525) min and 218 (40-500) mL respectively. Pancreatic fistula and delayed gastric emptying were noted in one patient each. No major complications occurred, but minor complications occurred in 5 (62%) patients. Mean hospital stay was 6.1 (range 3-14) days. At median follow-up of 18.15 (interquartile range 7.25-33.8) months, all patients experienced a resolution of pancreatitis and improvement in symptoms.

CONCLUSIONS

PD is a safe procedure for GP. Short-term surgical outcomes are acceptable and long-term outcomes are associated with improved symptom control.

摘要

背景/目的:沟部胰腺炎(GP)的手术治疗仍存在争议,胰十二指肠切除术(PD)对患者来说可能是一种高风险手术。本研究的目的是报告我们9年来GP手术切除的经验并回顾相关文献。

方法

对2008年8月1日至2017年5月31日期间因GP接受胰腺切除术的患者进行回顾性研究。纳入临床、影像学及最终病理确诊为GP的患者。回顾了关于GP目前认识的文献。

结果

449例胰腺切除术中8例患者符合纳入标准。4例男性和4例女性患者(平均年龄51.9岁;平均体重指数25.3)接受了保留幽门的胰十二指肠切除术(3例腹腔镜手术,5例开放手术)。平均(范围)手术时间和失血量分别为343(167 - 525)分钟和218(40 - 500)毫升。各有1例患者出现胰瘘和胃排空延迟。未发生重大并发症,但5例(62%)患者出现轻微并发症。平均住院时间为6.1(范围3 - 14)天。中位随访18.15(四分位间距7.25 - 33.8)个月时,所有患者胰腺炎均缓解,症状改善。

结论

PD对GP是一种安全的手术。短期手术效果可接受,长期效果与症状控制改善相关。

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