Schoretsanitis G N, Tsiftsis D D, Tatoulis P A, Gontikakis E T
Department of Surgical Oncology, University General Hospital, Herakleion, Crete, Greece.
Eur J Surg. 1993 Aug;159(8):421-4.
To describe a new and safe technique for draining the residual pancreatic duct after pancreaticoduodenectomy.
Open study.
University Hospital, Herakleion, Crete.
Eight patients with histological proved cancer of the periampullary region.
Pancreaticoduodenectomy (Whipple procedure), after which the remnant of the pancreatic duct was not anastomosed to the jejunum but drained externally through a soft polyethylene tube. All patients received total enteral or parenteral nutrition, plus somatostatin.
Avoidance of the high morbidity associated with pancreaticoduodenectomy, in particular pancreatic fistula secondary to leakage from the pancreaticojejunal anastomosis.
There was no immediate postoperative mortality or morbidity. The output from the pancreatic remnant decreased progressively, and had ceased in all cases within 20 days; the tube was removed when drainage ceased. Median hospital stay was 24 days (range 20-28). Two patients died after 9 and 11 months, respectively, and the remainder were alive at a median of 26.5 months (range 7-38). Blood glucose concentrations remained within the reference range throughout.
The technique of external drainage of the pancreatic remnant can safely be combined with a Whipple procedure, ameliorating the risk of postoperative complications and at the same time preserving pancreatic endocrine function.
描述一种在胰十二指肠切除术后引流残余胰管的新的安全技术。
开放性研究。
克里特岛伊拉克利翁大学医院。
8例经组织学证实为壶腹周围区域癌的患者。
胰十二指肠切除术（惠普尔手术），术后胰管残余部分不与空肠吻合，而是通过一根柔软的聚乙烯管向外引流。所有患者均接受全肠内或肠外营养，并加用生长抑素。
避免与胰十二指肠切除术相关的高发病率，尤其是胰肠吻合口漏导致的胰瘘。
术后无即刻死亡或发病情况。胰残余部分的引流量逐渐减少，所有病例在20天内引流均停止；引流停止后拔除导管。中位住院时间为24天（范围20 - 28天）。两名患者分别在9个月和11个月后死亡，其余患者存活，中位生存期为26.5个月（范围7 - 38个月）。血糖浓度始终保持在参考范围内。
胰残余部分的外引流技术可安全地与惠普尔手术相结合，降低术后并发症风险，同时保留胰腺内分泌功能。
