Meinke W B, Twomey P L, Guernsey J M, Frey C F, Higgins G, Keehn R
Arch Surg. 1983 May;118(5):550-3. doi: 10.1001/archsurg.1983.01390050034006.
Gastroenterostomy as part of the palliation of unresectable cancer of the head of the pancreas, in the absence of gastric outlet obstruction at the time of surgery, has been both rejected, and, more recently, advocated for all such patients. A study of 105 cases yielded four factors that correlated with the subsequent occurrence of gastric outlet obstruction: age, 60 years or younger; hemoglobin level, 11.5 g/dL or less; absence of liver metastases; and survival, three months or longer. A fifth factor, absence of clinical jaundice, may be an indicator of a poor prognosis with a small risk of obstruction. By combining factors, we identified a group with a risk of obstruction of at least 25% (those with two or more factors) and one with negligible risk.
作为无法切除的胰头癌姑息治疗的一部分，在手术时不存在胃出口梗阻的情况下，胃肠吻合术既遭到了摒弃，而最近又被提倡应用于所有此类患者。一项对105例病例的研究得出了与随后发生胃出口梗阻相关的四个因素：年龄60岁或以下；血红蛋白水平11.5 g/dL或更低；无肝转移；以及生存期三个月或更长。第五个因素，无临床黄疸，可能是预后不良且梗阻风险较小的一个指标。通过综合这些因素，我们确定了一组梗阻风险至少为25%的患者（具有两个或更多因素的患者）和一组风险可忽略不计的患者。
