Schlosser W, Schoenberg M H, Poch B, Siech M, Kunz R, Beger H G
Abteilung für Allgemeinchirurgie, Chirurgische Universitätsklinik Ulm.
Z Gastroenterol. 1996 Nov;34(11):735-41.
15 to 30% of the patients with chronic pancreatitis develop an inflammatory mass in the pancreatic head. The leading symptoms of these patients are severe upper abdominal pain and complications of the surrounding organs. From 1969 to 1995, 380 patients were treated with a duodenumpreserving pancreatic head resection. The cause of the disease was alcohol abuse in 81%. 93% of the patients suffered from severe pain with recurrent pain attacks. CT-scan revealed enlargement of the pancreatic head (> 4 cm in diameter) in 79% of the patients. 83% of the patients had an impaired exocrine pancreatic function; 48% of the patients had an impaired glucose tolerance or were diabetic. The hospital mortality was 0.8%; 5% of all patients had to be reoperated. The mean duration of the hospitalization was 13.9 days. 89% of the patients showed an unchanged endocrine function in the early postoperative course. The glucose metabolism was improved in 9%, 2% had a deteriorated function. The duodenum-preserving pancreatic head resection is a procedure with a low postoperative mortality and morbidity without deterioration of the endocrine pancreatic function.
15%至30%的慢性胰腺炎患者会在胰头部形成炎性肿块。这些患者的主要症状是严重的上腹部疼痛以及周围器官的并发症。1969年至1995年期间,380例患者接受了保留十二指肠的胰头切除术。81%的患者病因是酒精滥用。93%的患者遭受严重疼痛且疼痛反复发作。CT扫描显示79%的患者胰头肿大(直径>4厘米)。83%的患者胰腺外分泌功能受损;48%的患者糖耐量受损或患有糖尿病。医院死亡率为0.8%;5%的患者需要再次手术。平均住院时间为13.9天。89%的患者在术后早期内分泌功能未发生变化。9%的患者糖代谢得到改善,2%的患者功能恶化。保留十二指肠的胰头切除术是一种术后死亡率和发病率较低且不会导致胰腺内分泌功能恶化的手术。