Schoenberg M H, Gansauge F, Kunz R
Klinik für Allgemeine Chirurgie, Universität Ulm.
Chirurg. 1997 Dec;68(12):1262-7. doi: 10.1007/s001040050356.
In a study compiling the data in a prospective manner, the value of the pylorus-preserving duodenopancreatectomy (PPPD) compared to partial duodenopancreatectomy (PD) in patients suffering from ductal pancreatic carcinoma was assessed. Postoperative morbidity, mortality and overall prognosis were analysed. From May 1990 to April 1995 130 patients entered the study; 61 underwent PD, 69 patients had PPPD. The patients were regularly followed up every 6 months and the median follow-up period for all patients was 36 months. PPPD in patients with ductal pancreatic head carcinoma without infiltration of the duodenum is the technically simpler and faster operation method with significantly less blood loss. Moreover, PPPD did not lead to increased postoperative complications. The median survival rate of patients in the PD group was 10.8 months, in the PPPD group 21 months. This significant difference derives from the fact that the tumor stages were unevenly distributed. Regarding the most common stage (stage III according to UICC) the median survival times were almost identical (PD group 10.1 months, PPPD group 11.2 months). The PPPD operation seems to be a sufficiently radical procedure which does not worsen the prognosis of the disease.
在一项前瞻性收集数据的研究中,评估了保留幽门的十二指肠胰腺切除术(PPPD)与部分十二指肠胰腺切除术(PD)相比,对导管腺癌患者的价值。分析了术后发病率、死亡率和总体预后。1990年5月至1995年4月,130例患者进入该研究;61例行PD,69例患者行PPPD。患者每6个月定期随访,所有患者的中位随访期为36个月。对于未侵犯十二指肠的导管胰头癌患者,PPPD是技术上更简单、更快的手术方法,失血量明显更少。此外,PPPD不会导致术后并发症增加。PD组患者的中位生存期为10.8个月,PPPD组为21个月。这种显著差异源于肿瘤分期分布不均。对于最常见的分期(根据国际抗癌联盟为III期),中位生存时间几乎相同(PD组10.1个月,PPPD组11.2个月)。PPPD手术似乎是一种足够根治性的手术,不会恶化疾病的预后。