惠普尔手术治疗沟部胰腺炎的结果：一项回顾性横断面研究。
Outcome of Whipple's procedure for Groove pancreatitis: A retrospective cross-sectional study.
作者信息
Dhali Arkadeep, Ray Sukanta, Ghosh Ranajoy, Misra Debashis, Dhali Gopal Krishna
机构信息
Department of GI Surgery, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020, West Bengal, India.
Department of GI Pathology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, 244 A. J. C. Bose Road, Kolkata, 700020, West Bengal, India.
出版信息
Ann Med Surg (Lond). 2022 Jun 17;79:104008. doi: 10.1016/j.amsu.2022.104008. eCollection 2022 Jul.
BACKGROUND
Groove pancreatitis (GP) is a rare form of chronic pancreatitis primarily affecting the pancreatoduodenal groove. Very few studies have been published from India. The aim of the present study is to report our experience with Whipple's procedure for GP.
METHODOLOGY
In this cross-sectional study, data of all patients who underwent Whipple's procedure for GP between August 2007 and July 2021 were retrospectively reviewed.
RESULTS
Of the total 504 Whipple's procedures, histopathologically proven GP was identified in 9 patients. All of them were male. Mean age at presentation was 42.66 ± 4.35 years. All of them had history of alcohol abuse. Eight (88.8%) of them had history of smoking. Postprandial abdominal discomfort and pain (n = 9, 100%) was the most common presenting symptom. Three (33.3%) patients had solid variety and six (66.6%) patients had cystic dystrophy of the duodenal wall. Two (22.2%) patients had mass in the head of the pancreas which was thought to be malignant. None of the patients underwent prior endoscopic management (stenting). Duration of surgery and blood loss was 330 (range, 300-379) minutes, and 250 (range, 200-750) ml respectively. There was no postoperative mortality. Postoperative complications developed in 5 (55.5%) patients. All the complications were managed conservatively. Median postoperative hospital stay was 10 (range, 9-16) days. Over a median follow-up of 41 (range, 12-120) months, complete remission of symptoms was achieved in 7 (78%) patients.
CONCLUSION
Whipple's procedure is safe with acceptable perioperative outcomes and good long-term symptom control.
背景
沟部胰腺炎（GP）是一种罕见的慢性胰腺炎形式，主要影响胰十二指肠沟。印度发表的相关研究极少。本研究的目的是报告我们应用Whipple手术治疗GP的经验。
方法
在这项横断面研究中，对2007年8月至2021年7月期间接受Whipple手术治疗GP的所有患者的数据进行了回顾性分析。
结果
在总共504例Whipple手术中，经组织病理学证实为GP的有9例。所有患者均为男性。就诊时的平均年龄为42.66±4.35岁。他们都有酗酒史。其中8例（88.8%）有吸烟史。餐后腹部不适和疼痛（n = 9，100%）是最常见的首发症状。3例（33.3%）患者十二指肠壁为实性病变，6例（66.6%）患者为囊性营养不良。2例（22.2%）患者胰腺头部有肿块，被认为是恶性的。所有患者均未接受过内镜治疗（支架置入）。手术时间和失血量分别为330（范围300 - 379）分钟和250（范围200 - 750）毫升。无术后死亡病例。5例（55.5%）患者出现术后并发症。所有并发症均经保守治疗。术后中位住院时间为10（范围9 - 16）天。在中位随访41（范围12 - 120）个月期间，7例（78%）患者症状完全缓解。
结论
Whipple手术安全，围手术期结果可接受，长期症状控制良好。
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