Aranha G V, Prinz R A, Greenlee H B, Freeark R J
Arch Surg. 1984 Jul;119(7):833-5. doi: 10.1001/archsurg.1984.01390190071016.
During a ten-year period, 16 patients with gastric outlet and duodenal obstruction due to inflammatory pancreatic disease were seen. The cause of obstruction was chronic pancreatitis in ten patients, pseudocysts with associated pancreatitis in five patients, and pancreatic abscess in one patient. All patients had nausea and vomiting, 14 had abdominal pain, and five had weight loss greater than 4.5 kg. Diagnosis was made by plain abdominal film in one case, upper gastrointestinal tract roentgenographic series in 15 cases, and endoscopy in 11 cases. Mobilization of the duodenum relieved the obstruction in two patients. Fixed obstruction remained in 14 patients. This was relieved by gastrojejunostomy in 12 patients. Gastrojejunostomy was combined with drainage of a pseudocyst in three patients, a dilated pancreatic duct in three patients, and a dilated common bile duct in four patients. Obstruction was relieved by pseudocyst drainage in two patients. Associated common duct and pancreatic duct obstruction must be identified preoperatively.
在十年期间，共诊治了16例因炎性胰腺疾病导致胃出口和十二指肠梗阻的患者。梗阻原因是10例为慢性胰腺炎，5例为伴有胰腺炎的假性囊肿，1例为胰腺脓肿。所有患者均有恶心和呕吐，14例有腹痛，5例体重减轻超过4.5千克。1例通过腹部平片诊断，15例通过上消化道X线造影系列诊断，11例通过内镜检查诊断。十二指肠松解术使2例患者的梗阻得到缓解。14例患者仍存在固定性梗阻。12例患者通过胃空肠吻合术使梗阻得到缓解。3例患者的胃空肠吻合术联合了假性囊肿引流，3例联合了扩张胰管引流，4例联合了扩张胆总管引流。2例患者通过假性囊肿引流使梗阻得到缓解。术前必须识别相关的胆总管和胰管梗阻。
