胰十二指肠切除术在胰头部慢性胰腺炎治疗中的应用和选择

目的 探讨胰十二指肠切除术在胰头部慢性胰腺炎治疗中的应用和选择。方法 回顾性分析我院1988年7月至1999年11月经胰十二指肠切除术和病理证实的10例胰头部慢性胰腺炎临床资料。结果 本组病人男性7例，妇性3例，年龄41－75岁，平均57.2岁。主要临床表现为腹痛、黄疸。影像学检查（B超、CT和ERCP）发现胰头部局限性肿大。9例行典型的Whipple手术，1例行保留幽门的胰十二指肠切除术。7例随访均无腹痛、糖尿病。结论 胰头部慢性胰腺炎早期诊断困难，重要的是与胰头癌相鉴别。胰十二指肠切除术治疗胰头部慢性胰腺炎的手术效果良好，其手术适应证的选择和手术时机的掌握至关重要。

Pancreaticoduodenectomy for treatment of chronic pancreatitis in head of pancreas

Objective To investigate the choice and use of pancreaticoduodenectomy in treatment of chronic pancreatitis (CP) in the head of pancreas. Methods The clinical data of 10 cases of pathologically confirmed CP in the head of pancreas treated with pancreaticoduodenectomy in our hospital from July 1998 to November 1999 were retrospectively analyzed. Results Of the 10 patients with an age ranging from 41 to 75 (mean=57 2), 7 were male and 3 female. The major clinical manifestations were abdominal pain and jaundice. Examinations including B US, CT and ERCP showed that it was local dilatation in the head of pancreas. Nine patients received Whipple procedure and the other 1 pylorus preserving pancreaticoduodenectomy. All the 7 patients who were followed up had no pain at all after the operation and none of them became diabetic. Conclusions Early diagnosis of CP in the head of pancreas is considerably difficult. It is important to distinguish pancreatitis from pancreatic head cancer. Pancreaticoduodenectomy is effective to treat this disease. It is of great importance to correctly choose operative indication at a proper time for pancreaticoduodenectomy if necessary.