胰十二指肠切除术153例临床分析

作者对二十年来施行的１５３例Ｗｈｉｐｐｌｅ手术进行了分析，并将其以１９９０年为界分为两个阶段进行了对照。术后并发症发生率为４１．２％，死亡率为５．２％，并发症中以胃潴留发生率最高（１１．８％），严重并发症依次为腹内感染、上消化道出血、胰瘘等。两个阶段的对照显示，手术死亡率从１９９０年前的１５．６％降至１９９０年以后的０．９％（Ｐ＜０．０１），手术并发症的发生率从４４．４％下降至３１．９％（Ｐ＜０．０５）。１９９０年以后并发症发生率仍然在３０％以上的原因主要由于保留幽门手术开展后胃潴留的发生率大大增加（１６．７％）。作者认为，手术并发症和死亡率的降低主要原因在于手术过程的顺利，配备有丰富经验人员的专业小组是重要的保障。

Clinical analysis of 153 pancreaticoduodenetomies

pancreaticoduodenectomies performed from 1976 to 1995 were analyzed.The morbidity was 41 2% and the mortality 5 2%.Delayed gastric emptying (DGE) was the most common complication,and severe complications included introabdominal abscess, upper GI bleeding,and pancreatic fistula.The mortality decreased significantly from 15 6% before 1990 to 0 9% after 1990 and the morbidity decreased from 44 4% to 31 9%,and delayed gastric emptying was the major cause of mobidity after 1990 in pylorus preserving procedures.