Watanapa P, Williamson R C
Department of Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
Br J Surg. 1993 Feb;80(2):237-9. doi: 10.1002/bjs.1800800241.
Twenty-five patients with irresectable carcinoma of the pancreatic head received a modified type of palliative bypass in which the transected bile duct and the gastric antrum were anastomosed to the same Roux loop of jejunum. There were 13 women and 12 men with a median age of 54 (range 35-74) years. All but three patients were jaundiced and 11 underwent preoperative biliary decompression. In 18 patients jaundiced at the time of operation, the median preoperative serum bilirubin level was 287 (range 57-804) mumol/l. The median operative time was 4.0 (range 2.5-6.0) h. There were no hospital deaths. Minor postoperative complications occurred in nine patients and the median hospital stay after operation was 13 (range 7-49) days. The median postoperative survival was 4.8 (range 1.5-11.5) months. This operation provides good palliation safely in selected patients with irresectable pancreatic carcinoma.
25例无法切除的胰头癌患者接受了一种改良式姑息性旁路手术，即将横断的胆管和胃窦吻合至同一空肠Roux袢。其中女性13例，男性12例，中位年龄54岁（范围35 - 74岁）。除3例患者外均有黄疸，11例患者术前行胆道减压。18例手术时伴有黄疸的患者，术前血清胆红素水平中位数为287μmol/l（范围57 - 804μmol/l）。中位手术时间为4.0小时（范围2.5 - 6.0小时）。无住院死亡病例。9例患者出现轻微术后并发症，术后中位住院时间为13天（范围7 - 49天）。术后中位生存期为4.8个月（范围1.5 - 11.5个月）。该手术能为部分无法切除的胰腺癌患者安全地提供良好的姑息治疗。
