Konishi M, Ryu M, Kinoshita T, Kawano N, Tanizaki H, Cho A
Department of Surgery, National Cancer Center Hospital East, Chiba, Japan.
Surg Today. 1997;27(5):429-33. doi: 10.1007/BF02385706.
From 1992 to 1995, we treated 25 patients who had unresectable pancreatic cancer with a stomach-preserving gastric bypass (SPGB). After as much of the stomach as possible was preserved, it was bypassed to the jejunum by end-to-side anastomosis. During the same period, five patients underwent other types of bypasses while 47 similar patients did not undergo gastric bypass. Although the mean operative time for SPGB was significantly longer than for other types of bypass, the mean intraoperative blood loss was similar. Operative morbidity with SPGB was 28%, and there were no operative deaths. In patients undergoing SPGB, the incidence of delayed gastric emptying was high (24%), but the comfort index (ratio of duration of good palliation to duration of survival) exceeded 50% when metastases were either regional or systemic but limited. The comfort index of patients undergoing other types of bypass or not undergoing bypass was less than 40%. However, the patients with extensive systemic metastases survived less than 100 days and the comfort index was less than 30% for all treatment groups. Our results thus suggest that SPGB is safe and effective for patients with either regional metastases or limited systemic metastases.
1992年至1995年期间，我们采用保留胃的胃旁路术（SPGB）治疗了25例无法切除的胰腺癌患者。在尽可能保留胃的大部分后，通过端侧吻合将其与空肠进行旁路吻合。同期，5例患者接受了其他类型的旁路手术，47例类似患者未接受胃旁路手术。尽管SPGB的平均手术时间明显长于其他类型的旁路手术，但术中平均失血量相似。SPGB的手术并发症发生率为28%，无手术死亡病例。接受SPGB的患者胃排空延迟发生率较高（24%），但当转移为局部或全身但局限时，舒适度指数（良好姑息持续时间与生存持续时间的比值）超过50%。接受其他类型旁路手术或未接受旁路手术的患者舒适度指数低于40%。然而，有广泛全身转移的患者存活时间不到100天，所有治疗组的舒适度指数均低于30%。因此，我们的结果表明，SPGB对局部转移或全身转移局限的患者是安全有效的。
