Frey C F, Smith G J
Department of Surgery, University of California, Davis Medical Center, Sacramento.
Pancreas. 1987;2(6):701-7. doi: 10.1097/00006676-198711000-00014.
An operation is described that is useful in the management of patients with chronic pancreatitis and its complications. The operation features duodenal-preserving resection of the head of the pancreas combined with longitudinal pancreaticojejunostomy of the body and tail of the pancreas. The operation has application to patients with pain or complications of chronic pancreatitis with dilated ducts in the body and tail of the pancreas who have small strictured ducts and/or small pseudocysts or ducts impacted with calculi in a markedly enlarged fibrotic pancreatic head. It also has application to patients with chronic pancreatitis complicated by common duct obstruction from small pseudocysts, fibrosis, or inflammation in the head of the pancreas. With this procedure, the common duct can often be freed up from the structures compressing it within the substance of the pancreas doing away with the necessity of a separate biliary bypass. The operation also has application to patients with a previous longitudinal pancreaticojejunostomy who have recurrent or persistent pain associated with small strictured ducts in an enlarged fibrotic pancreatic head with or without common bile duct obstruction.
本文描述了一种对慢性胰腺炎及其并发症患者的治疗有用的手术。该手术的特点是保留十二指肠的胰头切除术，联合胰体尾纵行胰空肠吻合术。该手术适用于患有慢性胰腺炎疼痛或并发症、胰体尾导管扩张、胰头明显增大纤维化且伴有小的狭窄导管和/或小的假性囊肿或结石嵌顿的患者。它也适用于因胰头小假性囊肿、纤维化或炎症导致胆总管梗阻的慢性胰腺炎患者。通过这种手术，胆总管通常可以从胰腺实质内压迫它的结构中游离出来，从而无需单独进行胆肠吻合术。该手术也适用于曾接受过纵行胰空肠吻合术、胰头增大纤维化且伴有或不伴有胆总管梗阻、存在与小的狭窄导管相关的复发性或持续性疼痛的患者。
