White T T, Slavotinek A H
Ann Surg. 1979 Feb;189(2):217-24. doi: 10.1097/00000658-197902000-00014.
The authors report on 142 patients treated surgically for chronic pancreatitis. They had an average age of 43.5; 34.5% were calcific; 62.7% were alcoholics: 28.9% had cysts; 19% had diabetes; 16.9% had steatorrhea; and all had pain. A follow-up of 55 patients undergoing pancreaticojejunostomy showed that, 4--21 years following operation 16 had marked improvement, 11 had some relief, four were not relieved from pain, and 24 had died, three within one month postoperatively and 21 later. Eighty to ninety-five per cent pancreatectomy was more effective in relieving pain in the 9 patients subjected to this type of resection than was the 50--80% pancreatic resection used in 16 patients. Pancreaticoduodenectomy was of some value in three of five patients so operated. Celiac ganglionectomy, used in 22 patients, and sphincteroplasty, used in 35 patients, were less effective in relieving symptoms than the other procedures.
作者报告了142例接受慢性胰腺炎手术治疗的患者。他们的平均年龄为43.5岁;34.5%为钙化型;62.7%为酗酒者;28.9%有囊肿;19%有糖尿病;16.9%有脂肪泻;所有患者均有疼痛。对55例行胰空肠吻合术的患者进行随访发现,术后4至21年,16例明显改善,11例有所缓解,4例疼痛未缓解,24例死亡,3例在术后1个月内死亡,21例之后死亡。在接受80%至95%胰腺切除术的9例患者中,这种手术方式在缓解疼痛方面比16例接受50%至80%胰腺切除术的患者更有效。在接受胰十二指肠切除术的5例患者中,有3例有一定效果。22例患者接受了腹腔神经节切除术,35例患者接受了括约肌成形术,与其他手术相比,这两种手术在缓解症状方面效果较差。