Gebhardt C, Zirngibl H, Gossler M
Langenbecks Arch Chir. 1981;354(3):209-20. doi: 10.1007/BF01254556.
Report on 143 left resections of the pancreas for chronic pancreatitis. Good late results (81% of all patients improved or symptom-free) can be obtained by this method only in corpus-cauda-pancreatitis. Because of better results the 80-95%-resection should be preferred to the 40-80%-resection. In diffuse pancreatitis, however, a poor result is obtained in 55% of all operations. The same can be observed in cases where the main inflammatory lesion is located in the head of the pancreas and where in addition to the left resection an end-to-end pancreatico-jejunostomy is performed. In this case the Whipple's procedure should be preferred which can be combined with an intraoperative occlusion of the duct system in the pancreatic tail in order to prevent recidivation of pancreatitis. Contrary to the partial duodenopancreatectomy the left resection of the pancreas postoperatively leads to an increase of diabetes mellitus (41%).
143例慢性胰腺炎胰腺左半切除术报告。仅在胰体尾胰腺炎中采用该方法可获得良好的远期效果(所有患者中81%病情改善或无症状)。由于效果更佳,应首选80% - 95%切除术而非40% - 80%切除术。然而,在弥漫性胰腺炎中,所有手术中有55%效果不佳。当主要炎症病变位于胰头,且除胰腺左半切除外还进行胰肠端端吻合术时,情况亦是如此。在此情况下,应首选惠普尔手术,可结合术中闭塞胰尾的导管系统以防止胰腺炎复发。与部分十二指肠胰腺切除术相反,胰腺左半切除术后糖尿病发病率会升高(41%)。