Walzel C
Wien Klin Wochenschr. 1976 Mar 19;88(6):212-5.
A case report is presented of a 38-year-old alcoholic welfare patient. Drainage of a pancreatic abscess, which had to be repeated, pyloromyotomy, cholecystectomy and sphincterotomy were undertaken in 1972 at another hospital. He was admitted on the present occasion because of weight loss, severe attacks of pain and diabetes. At operation multiple necrotic areas were found in the pancreas, with many stones in the parenchymatous tissue and in the main pancreatic duct and one large stone close to the pailla acting like a valve. Sub-total duodenopancreatectomy, resection of the pyloric region of the stomach, retrocolic hepaticojejunostomy and gastroenteroanastomosis was performed. The postoperative recovery took place without complications. 5 days after discharge the patient died in a hypoglycaemic coma at another hospital. He had administered 400 U. insulin to himself whilst in a drunken state. A short description is given of the aetiology and pathogenesis of calcifying pancreatitis. The choice of the surgical technique depends on the operative findings and the aim of therapy. Attention is called to the increase in late mortality in patients with pancreatectomy who do not abstain from alcohol.
本文报告一例38岁的酗酒福利患者。1972年在另一家医院进行了胰腺脓肿引流(该操作不得不重复进行)、幽门肌切开术、胆囊切除术和括约肌切开术。他此次因体重减轻、剧烈疼痛发作和糖尿病入院。手术中发现胰腺有多个坏死区域,实质组织和主胰管内有许多结石,靠近乳头处有一个大结石,其作用类似瓣膜。实施了十二指肠胰腺次全切除术、胃幽门区切除术、结肠后肝空肠吻合术和胃肠吻合术。术后恢复过程无并发症。出院5天后,患者在另一家医院死于低血糖昏迷。他在醉酒状态下给自己注射了400单位胰岛素。简要描述了钙化性胰腺炎的病因和发病机制。手术技术的选择取决于手术所见和治疗目的。需注意的是,未戒酒的胰腺切除患者晚期死亡率会增加。