Sikora S S, Posner M C
Department of Surgery, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Br J Surg. 1995 Dec;82(12):1590-7. doi: 10.1002/bjs.1800821205.
Pancreaticoduodenectomy is the procedure of choice in patients with periampullary and pancreatic cancers. Dramatic improvements in morbidity and mortality rates following pancreaticoduodenectomy have been reported in the past 5 years. Consequently, the indications for pancreaticoduodenectomy are becoming more liberal, with some authors suggesting its use as a palliative procedure in pancreatic cancer and as definitive treatment for benign diseases such as chronic pancreatitis. Complications are frequently related to the pancreatic stump and can have a fatal outcome. Several methods of managing the pancreatic stump have been described, with variable results. Modifications of standard techniques have evolved over time in an effort to reduce the incidence of major complications. The results of these methods, the role of perioperative adjuncts and the long-term outcome of pancreaticoenteric anastomosis are reviewed.
胰十二指肠切除术是壶腹周围癌和胰腺癌患者的首选手术方式。过去5年里，有报道称胰十二指肠切除术后的发病率和死亡率有了显著改善。因此，胰十二指肠切除术的适应证正变得更加宽松，一些作者建议将其用于胰腺癌的姑息性手术以及慢性胰腺炎等良性疾病的确定性治疗。并发症常与胰腺残端相关，可能导致致命后果。已经描述了几种处理胰腺残端的方法，结果各不相同。随着时间的推移，标准技术不断改进，以降低严重并发症的发生率。本文对这些方法的结果、围手术期辅助治疗的作用以及胰肠吻合术的长期疗效进行了综述。
