联合血管切除重建治疗胰头肿块型慢性胰腺炎

目的 探讨联合血管切除重建的胰头十二指肠切除术治疗胰头肿块型慢性胰腺炎的必要性和合理性.方法 回顾性分析我科自2000年1月～2006年3月收治胰头肿块患者13例,其中男10例,女3例,年龄37～71岁,平均51岁,行联合门静脉、肠系膜上静脉切除重建的胰头十二指肠切除术.结果 13例患者均经病理证实为慢性胰腺炎,术后无死亡病例,发生胃排空障碍1例,经保守治疗治愈;胰瘘1例,经引流、给予生长抑素等保守治疗治愈.随访19～86个月,13例患者疼痛症状均消失,至今未复发,黄疸均消退无复发.结论 对于胰头慢性炎症组织粘连周围血管,术中难以分离的病例,联合血管切除重建增加了切除率,手术安全,可大大提高患者的生活质量,且避免了遗漏炎症组织内癌灶而失去了治愈的机会.

Combined vascular reconstruction in the treatment of chronic pancreatitis with lump in the head

Objective To discuss the necessity and rationality of regional pancreatoduodenectomy combined vas-cular reconstruction in the treatment of chronic pancreatitis with lump in the head. Methods Thirteen patients who suffered from pancreas with lump in the head, were operated in our department from January 2000 to March 2006. The clinical data were analyzed retrospectively,there were 10 men and 3 women with an age ranging from 37 to 71 (mean = 51 ), all the patients underwent pancreatoduodenectomy combined PV and SMV reconstruction. Results All thirteen patients were pathologically confirmed chronic pancreatitis without postoperative deaths, in which stom-ach empty disorder and pancreatic fistula occurred and were cured conservatively in one case. All the 13 patients who were followed up 19～86 months had no pain and jaundice at all after the operation. Conclusion Combined vascular reconstruction to treat the lump in the head of the pancreas that packages blood vessel and hard to separa-tion is proved to be a safe and reliable method, being capable of raising lump resection rate, which can improve quality of life of patients remarkably to avoid omit minimum cancer in lump to result in lose the curative opportunity.