Büchler M W, Friess H, Müller M W, Beger H G
Klinik für Viszerale und Transplantationschirurgie, Universität Bern, Inselspital.
Langenbecks Arch Chir Suppl Kongressbd. 1997;114:1081-3.
Between 1972 and 1993, 298 patients with chronic pancreatitis underwent a duodenum-preserving pancreatic head resection (DPPHR). The early and late outcomes were prospectively analyzed. An operative mortality rate of 1%, a postoperative morbidity rate of 28.5% and a relaparotomy rate of 5.7% for the DPPHR were competitive with the rates for Whipple resection. After a median late follow-up of 6 years (range: 1 to 22 years), late mortality was 9%; 88% of the patients had no or infrequent episodes of pain and 63% were completely rehabilitated professionally. Only 6 patients developed diabetes mellitus early postoperatively. Our study proves that the duodenum-preserving pancreatic head resection provides better results than the Whipple resection. Therefore, this operation should be adopted as a new standard operation in patients with chronic pancreatitis.
1972年至1993年间,298例慢性胰腺炎患者接受了保留十二指肠的胰头切除术(DPPHR)。对其早期和晚期结果进行了前瞻性分析。DPPHR的手术死亡率为1%,术后发病率为28.5%,再次剖腹手术率为5.7%,与惠普尔手术的相应比率具有可比性。在中位时间为6年(范围:1至22年)的晚期随访后,晚期死亡率为9%;88%的患者无疼痛发作或疼痛发作不频繁,63%的患者职业上完全康复。术后早期仅6例患者发生糖尿病。我们的研究证明,保留十二指肠的胰头切除术比惠普尔手术效果更好。因此,该手术应作为慢性胰腺炎患者的新标准手术采用。