Meyer J, Sulkowski U, Bünte H, Clemens M, Reers B
Zentralbl Chir. 1985;110(20):1242-9.
From 1974 to 1983, 112 patients were treated at the Chirurgische Universitätsklinik Münster according to the procedure first published by Whipple in 1935. 40 patients (35.7%) were operated for chronic pancreatitis, 39 for (34.8%) ampullary cancer and 33 (29.5%) for pancreatic cancer. As to operative mortality which amounted to 10.7% (12/112) for all patients, figures of 10.0% (4/40) could be found for relapsing pancreatitis and 7.7% or 15.2% respectively for cancer patients. The underlying cause was circulatory arrest in 6 cases, anastomotic leakage in 4 cases, liver failure and gas gangrene in 1 case each. Altogether eight relaparotomies were performed (7.1%). As non-letal complications, pancreatic fistula, rise of liver enzymes, wound healing disturbances, and pleural effusion were the most frequent non-letal complications. By using the Ethibloc for pancreatic duct occlusion the rate of complications could be lowered. Hardly ever, glucose-metabolism was markedly affected by this extensive procedure.
1974年至1983年期间，明斯特大学外科诊所按照1935年Whipple首次发表的手术方法治疗了112例患者。其中，40例（35.7%）因慢性胰腺炎接受手术，39例（34.8%）因壶腹癌接受手术，33例（29.5%）因胰腺癌接受手术。所有患者的手术死亡率为10.7%（12/112），复发性胰腺炎患者的手术死亡率为10.0%（4/40），癌症患者的手术死亡率分别为7.7%和15.2%。死亡原因包括6例循环骤停、4例吻合口漏、各1例肝衰竭和气性坏疽。总共进行了8次再次剖腹手术（7.1%）。作为非致命性并发症，胰瘘、肝酶升高、伤口愈合障碍和胸腔积液是最常见的非致命性并发症之一。通过使用Ethibloc封闭胰管，并发症发生率得以降低。这种广泛的手术很少会显著影响糖代谢。
