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慢性胰腺炎外科治疗的新概念(作者译)

[A new concept in the surgery of chronic pancreatitis (author's transl)].

作者信息

Gall F P, Gebhardt C

出版信息

Dtsch Med Wochenschr. 1979 Jul 13;104(28):1003-6. doi: 10.1055/s-0028-1129026.

Abstract

There is an obvious advantage to partial duodenopancreatectomy with occlusion of the pancreatic duct by prolamine (a rapidly solidifying aminoacid solution) for the prevention of recurrences, while preserving the stomach and proximal duodenum, in the treatment of severe destruction of the pancreas, localised to the head or generalised. The death rate of partial duodenopancreactectomy has been lowered from 8.5 to 2.3% since using this method. Compared with total duodenopancreatectomy which--according to the authors' earlier results carried a postoperative mortality of 20%--the operative risk has been reduced to a tenth. Taking into account the benign nature of chronic pancreatitis, on the other hand, and the extent of the operative operation, on the other, the present death-rate of 2.3% would appear reasonable. Occlusion of the pancreatic duct with prolamine in order to exclude any still present excretory pancreatic function in the residual pancreatic tissue has made all patients pain-free. No early recurrence has been observed.

摘要

对于胰腺严重破坏局限于头部或呈弥漫性的情况,在治疗时采用醇溶谷蛋白(一种快速凝固的氨基酸溶液)阻塞胰管进行部分十二指肠胰腺切除术,在保留胃和十二指肠近端的同时预防复发,具有明显优势。自采用该方法以来,部分十二指肠胰腺切除术的死亡率已从8.5%降至2.3%。与全十二指肠胰腺切除术相比——根据作者早期结果,其术后死亡率为20%——手术风险已降至十分之一。另一方面,考虑到慢性胰腺炎的良性性质以及手术范围,目前2.3%的死亡率似乎是合理的。用醇溶谷蛋白阻塞胰管以排除残余胰腺组织中任何仍存在的胰腺排泄功能,使所有患者都不再疼痛。未观察到早期复发情况。

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