Deschamps G, Bourbeau D
Can J Surg. 1984 Nov;27(6):559-60.
There is controversy in the literature over the surgical treatment of pancreatic carcinoma, especially whether gastro-enterostomy should be performed prophylactically when palliative biliary bypass is done. The authors report a retrospective study of 184 patients with pancreatic carcinoma treated at the Hôtel-Dieu Hospital in Montreal between 1970 and 1982. Of these, 106 patients had cancer of the head of the pancreas. In this group, 15 had a Whipple procedure. Median survival was 512 days with no 5-year survivors. Forty-nine patients had biliary bypass alone and 3 needed gastroenterostomy later for duodenal obstruction. Eleven patients had both biliary--enteric bypass and gastroenterostomy. Biliary bypass using the common duct gives the same result as that using the gallbladder. Considering their reoperation rate of only 7.3%, the authors do not believe that prophylactic gastroenterostomy is indicated in these patients.
关于胰腺癌的外科治疗，尤其是在进行姑息性胆管旁路手术时是否应预防性地施行胃肠吻合术，文献中存在争议。作者报告了一项对1970年至1982年间在蒙特利尔迪厄医院接受治疗的184例胰腺癌患者的回顾性研究。其中，106例患者患有胰头癌。在这组患者中，15例行惠普尔手术。中位生存期为512天，无5年存活者。49例患者仅接受了胆管旁路手术，3例后来因十二指肠梗阻需要行胃肠吻合术。11例患者同时接受了胆肠旁路和胃肠吻合术。使用胆总管进行胆管旁路手术与使用胆囊进行手术的结果相同。考虑到这些患者的再次手术率仅为7.3%，作者认为这些患者无需进行预防性胃肠吻合术。
