Izbicki J R, Bloechle C, Knoefel W T, Wilker D K, Dornschneider G, Broelsch C E
Abteilung für Allgemeinchirurgie, Universitäts-Krankenhaus Eppendorf, Universität Hamburg.
Z Gastroenterol. 1995 Mar;33(3):159-65.
Chronic pancreatitis frequently generates complications through involvement of adjacent organs. Distal common bile duct stenosis or segmental duodenal stenosis, the most frequent complications, are usually treated by resective or by-passing procedures. This study presents the experience with an organ and functionality sparing procedure in the treatment of chronic pancreatitis with predominant involvement of the pancreatic head and coexisting organ complications. Sixty-eight patients with severe chronic pancreatitis underwent duodenum preserving resection of the head of the pancreas. Fourty-one of these patients presented with organ complications: fourty with distal common bile duct stenosis, eight with duodenal stenosis, thirteen with segmental portal hypertension, and one patient suffered from a pancreatico-pleural fistula. All patients were prospectively documented. Mean follow-up was 4.1 years. 93% of the organ complications were permanently eradicated. Three patients (7%) exhibited transitory cholestasis. 88% of the patients reported complete relief of all symptoms. Duodenum preserving resection of the head of the pancreas is effective to treat severe chronic pancreatitis with predominant involvement of the pancreatic head. It also provides definitive management of associated organ complications.
慢性胰腺炎常因累及邻近器官而引发并发症。最常见的并发症——胆总管远端狭窄或节段性十二指肠狭窄，通常采用切除或旁路手术治疗。本研究介绍了一种保留器官和功能的手术方法，用于治疗以胰头为主且伴有器官并发症的慢性胰腺炎。68例重症慢性胰腺炎患者接受了保留十二指肠的胰头切除术。其中41例患者存在器官并发症：40例胆总管远端狭窄，8例十二指肠狭窄，13例节段性门静脉高压，1例患者患有胰胸膜瘘。所有患者均进行了前瞻性记录。平均随访4.1年。93%的器官并发症得到了永久性根除。3例患者（7%）出现暂时性胆汁淤积。88%的患者报告所有症状完全缓解。保留十二指肠的胰头切除术对于治疗以胰头为主的重症慢性胰腺炎有效。它还能对相关器官并发症进行确定性治疗。
