Schoenberg M H, Hepp G, Beger H G
Chirurgische Klinik des Rotkreuz-Krankenhauses, München.
Chirurg. 1998 Jun;69(6):633-8. doi: 10.1007/s001040050467.
Benign tumors of the pancreatic head are normally treated by a partial duodenopancreatectomy. This operation has been developed for the treatment of malignant alterations in the pancreatic head and includes resection of the gastric bowel, duodenum and common bile duct. The aim of this study was to evaluate whether the less radical duodenum-preserving pancreatic head resection is a suitable surgical procedure in the treatment of benign pancreatic head tumors. From May 1982 to December 1996, seven patients underwent surgical treatment for benign pancreatic head tumors. Two patients suffered from gastrinoma of the pancreatic head, four exhibited a serous or mucinous cystadenoma, and one patient suffered from an intraductal papillary-mucinous tumor in this region. All patients were treated by duodenum-preserving pancreatic head resection. The operation was easily performed with little blood loss and a low rate of complications. None of the patients had to be reoperated upon due to postoperative surgical complications. After a follow-up period of a median 3 years, six of seven patients were had no recurrence of the disease and were symptom-free. One patient who had initially been operated on for gastrinoma still exhibited high gastrin values postoperatively. The endocrine and exocrine pancreatic function was not impaired in the early and late postoperative phase as compared to the preoperative assessment. From our results, it is concluded that duodenum-preserving pancreatic head resection is an adequately radical, yet organ-preserving procedure for the treatment of benign tumors of the pancreatic head without compromising endocrine and exocrine function.
胰头良性肿瘤通常采用十二指肠胰腺部分切除术进行治疗。该手术是为治疗胰头恶性病变而开发的,包括切除胃、十二指肠和胆总管。本研究的目的是评估保留十二指肠的胰头切除术这种创伤较小的手术方法是否适合治疗胰头良性肿瘤。1982年5月至1996年12月,7例胰头良性肿瘤患者接受了手术治疗。2例患有胰头胃泌素瘤,4例表现为浆液性或黏液性囊腺瘤,1例患有该区域的导管内乳头状黏液性肿瘤。所有患者均接受了保留十二指肠的胰头切除术。手术操作简便,出血量少,并发症发生率低。没有患者因术后手术并发症而需要再次手术。经过中位3年的随访期,7例患者中有6例疾病无复发且无症状。1例最初因胃泌素瘤接受手术的患者术后胃泌素值仍较高。与术前评估相比,术后早期和晚期胰腺的内分泌和外分泌功能均未受损。根据我们的结果,得出结论:保留十二指肠的胰头切除术是一种足够彻底但又能保留器官的手术方法,用于治疗胰头良性肿瘤,且不会损害内分泌和外分泌功能。