Röthlin M, Schöb O, Weder W, Buchmann P, Largiadèr F
Departement Chirurgie, Universitätsspital Zürich.
Helv Chir Acta. 1993 Sep;60(1-2):111-5.
There has been a controversy for years concerning the value of the prophylactic gastroenterostomy (GE) in patients suffering from irresectable pancreatic cancer. A retrospective analysis of the patients undergoing palliative bypass-operations for pancreatic cancer at Zurich University Hospital between 1982 and 1990 revealed 53 patients (28 male, 25 female) with an average age of 68 years. Twenty-one patients received a double bypass, 18 received a hepaticojejunostomy, 12 a primary and 2 a secondary GE. Mortality and morbidity for double bypass were 14% and 33%, for hepaticojejunostomy 5% and 28% and for primary GE 25% and 50%. Secondary GE was associated with a mortality and morbidity of 1 of 2 cases. Two patients received a secondary GE and two more showed signs of duodenal obstruction amounting to 20% incidence for secondary duodenal obstruction. Delayed gastric emptying was observed in only 2 patients with primary GE. These data suggest the use of a prophylactic double bypass.
多年来，关于预防性胃肠吻合术（GE）在无法切除的胰腺癌患者中的价值一直存在争议。对1982年至1990年间在苏黎世大学医院接受胰腺癌姑息性搭桥手术的患者进行的回顾性分析显示，共有53例患者（28例男性，25例女性），平均年龄68岁。21例患者接受了双旁路手术，18例接受了肝空肠吻合术，12例接受了一期GE，2例接受了二期GE。双旁路手术的死亡率和发病率分别为14%和33%，肝空肠吻合术为5%和28%，一期GE为25%和50%。二期GE在2例患者中有1例出现死亡和发病情况。2例患者接受了二期GE，另外2例出现十二指肠梗阻迹象，二期十二指肠梗阻发生率为20%。仅2例一期GE患者出现胃排空延迟。这些数据表明应采用预防性双旁路手术。
