Schantz S P, Schickler W, Evans T K, Coffey R J
Am J Surg. 1984 Jun;147(6):793-6. doi: 10.1016/0002-9610(84)90203-4.
The records of 125 consecutive patients with unresectable pancreatic cancer treated between 1958 and 1979 were evaluated to determine the benefit or morbidity of gastroenterostomy performed on a routine basis. One hundred three patients had no evidence of gastric outlet obstruction from tumor extension as determined at the time of initial operation. Fifty-seven of these patients underwent biliary diversion as their only operative procedure. The morbidity and mortality in this group was 31 and 14 percent, respectively. Six of these 57 patients required decompressing gastroenterostomy at a later date to relieve gastric outlet obstruction. Forty-six patients underwent both biliary and prophylactic gastric outlet diversion with a 15 percent mortality rate and a 46 percent incidence of morbidity. The most common complication in this group was delayed gastric emptying (14 percent). These findings, and the high incidence of delayed gastric emptying after gastroenterostomy and the relatively infrequent occurrence of gastric outlet obstruction (11 percent) after initial biliary diversion, suggest that gastroenterostomy should be performed on a selective basis only.
对1958年至1979年间接受治疗的125例连续性不可切除胰腺癌患者的记录进行评估，以确定常规实施胃肠造口术的益处或发病率。103例患者在初次手术时未发现因肿瘤侵犯导致胃出口梗阻的证据。其中57例患者仅接受了胆道改道作为唯一的手术操作。该组患者的发病率和死亡率分别为31%和14%。这57例患者中有6例在之后需要进行减压性胃肠造口术以缓解胃出口梗阻。46例患者同时接受了胆道和预防性胃出口改道手术，死亡率为15%，发病率为46%。该组最常见的并发症是胃排空延迟（14%）。这些发现，以及胃肠造口术后胃排空延迟的高发生率和初次胆道改道后胃出口梗阻相对较少的发生率（11%），表明胃肠造口术应仅在选择性基础上进行。
