Partensky C, Apa D, Marchal F, Méziat A, Berger F
Service de chirurgie digestive, fédération des spécialités digestives, hôpital Edouard-Herriot, Lyon, France.
Chirurgie. 1998 Sep;123(4):363-7. doi: 10.1016/s0001-4001(98)80006-8.
To report a personal series of ten patients who underwent a medial pancreatectomy with pancreaticogastrostomy for tumor of the pancreas.
An equal number of five patients had solid and cystic tumors. The solid tumors were all endocrine and included two cases of insulinoma and solitary cases of VIPoma, glucagonoma, and non-secreting tumor. Five patients had a cystic tumor which was in two cases a serous cystadenoma, and in the other cases, a mucinous cystadenoma, a solid pseudopapillary tumor, and a solitary hydatid cyst of the pancreas. The operative procedure included a middle segment pancreatectomy, a suture of the proximal pancreatic stump, an anastomosis of the distal pancreatic stump with the stomach and an external transgastric drainage of the distal main pancreatic duct.
In the postoperative course, a sero-hematic collection close to the anastomosis occurred in four patients and required external drainage in three cases. All patients recovered without sequela of pancreatic dysfunction.
This series confirms the place of medial pancreatectomy in resection of non-enucleable tumors of the middle part of the pancreas. It also shows that pancreaticogastrostomy is a technical simplification compared to Roux-en Y pancreaticojejunostomy in this particular modality of pancreatectomy.
报告一组接受胰腺中段切除术加胰胃吻合术治疗胰腺肿瘤的10例患者。
5例患者为实性肿瘤，5例为囊性肿瘤。实性肿瘤均为内分泌肿瘤，包括2例胰岛素瘤，以及各1例血管活性肠肽瘤、胰高血糖素瘤和无功能性肿瘤。5例囊性肿瘤患者中，2例为浆液性囊腺瘤，其余分别为黏液性囊腺瘤、实性假乳头状肿瘤和胰腺孤立性包虫囊肿。手术步骤包括胰腺中段切除术、胰腺近端残端缝合、胰腺远端残端与胃吻合以及经胃对胰腺主胰管远端进行外引流。
术后过程中，4例患者在吻合口附近出现血清-血液积聚，3例需要进行外引流。所有患者均康复，未出现胰腺功能障碍后遗症。
该系列病例证实了胰腺中段切除术在切除胰腺中部不可摘除肿瘤中的地位。同时表明，在这种特定的胰腺切除方式中，与 Roux-en Y 胰空肠吻合术相比，胰胃吻合术技术更为简化。
