Melvin W S, Buekers K S, Muscarella P, Johnson J A, Schirmer W J, Ellison E C
Division of General Surgery, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
J Gastrointest Surg. 1998 Jan-Feb;2(1):72-8. doi: 10.1016/s1091-255x(98)80106-6.
The long-term sequelae of pancreaticoduodenectomy are not completely understood. In the present study nutritional status, pancreatic function, and subjective quality-of-life parameters were evaluated in 45 patients who had previously undergone either pylorus-preserving pancreaticoduodenectomy (PPPD) or standard pancreaticoduodenectomy (SPD). Quality-of-life parameters, as measured by the Short Form-36 health survey, demonstrated no significant differences between the subgroups and normal control subjects in six of the eight domains for physical and mental health. Patients who had undergone SPD were noted to have significantly lower scores for general health and vitality than either age-matched control subjects or those who had undergone PPPD. No differences in nutritional parameters or indicators of pancreatic exocrine function between the two groups were identified. An elevated hemoglobin A1c value was seen in only one patient who was not diabetic preoperatively. Our data indicate that long-term survivors of pancreaticoduodenectomy generally feel as good as their normal counterparts, although SPD may result in some health satisfaction deficits. Nutritional status and pancreatic exocrine function are not improved in patients undergoing a pylorus-preserving procedure, and postoperative pancreatic endocrine dysfunction is unusual in both groups.
胰十二指肠切除术的长期后遗症尚未完全明确。在本研究中，对45例既往接受过保留幽门胰十二指肠切除术（PPPD）或标准胰十二指肠切除术（SPD）的患者的营养状况、胰腺功能和主观生活质量参数进行了评估。通过简短健康调查问卷（Short Form-36）测量的生活质量参数显示，在身体和心理健康的八个领域中的六个领域，亚组与正常对照受试者之间没有显著差异。接受SPD的患者在总体健康和活力方面的得分显著低于年龄匹配的对照受试者或接受PPPD的患者。两组之间在营养参数或胰腺外分泌功能指标方面未发现差异。仅1例术前无糖尿病的患者糖化血红蛋白（A1c）值升高。我们的数据表明，胰十二指肠切除术的长期存活者总体感觉与正常人一样良好，尽管SPD可能会导致一些健康满意度方面的缺陷。接受保留幽门手术的患者营养状况和胰腺外分泌功能并未改善，且两组术后胰腺内分泌功能障碍均不常见。
