中段胰腺切除术19例报告

目的 研究中段胰腺切除术在胰腺外科中的应用及临床意义.方法 回顾性分析山东大学附属省立医院2002年1月至2008年6月期间行中段胰腺切除术的19例患者的临床资料.结果 19例患者中9例为胰岛细胞瘤,4例为胰腺黏液性囊腺瘤,3例为胰腺实性假乳头状瘤,2例为胰腺类癌,1例为胰腺囊实性假性乳头状瘤,切缘均为阴性.住院时间10～40 d,平均(17.7±7.9)d,术后胰漏发生率为31.6%.随访时间为6个月至6年不等,除了1例患者随访1.5年后失访外,其余患者均健在,且无肿瘤复发和新发糖尿病病例.结论 中段胰腺切除术对于生长在胰腺颈部或体部的良性或低度恶性肿瘤是一种良好的手术方式,可保留患者的内外分泌功能,减轻胰腺切除术后糖尿病的风险.

Middle pancreatectomy, a report of 19 cases

Objective To evaluate central pancreatectomy in pancreatic surgery. Methods The clinical data of 19 patients who received central pancreatectomy was retrospectively analyzed in the Provincial Hospital, Shandong University from Jan 2002 to Jun 2008. Results Among 19 patients, 9 patients were of islet cell tumor,4 patients were mucinous cystoadenoma,3 patients were solid pseudopapilloma, 2 patients were pancreatic carcinoid tumor, 1 patient was of cyst-solid pseudopapilloma. After resection all of them had pathological negative margin. Length of stay was ( 17. 7 ± 7. 9) days ( ranging from 10 to 40 days ). Incidence of pancreatic fistula after this pancreatectomy was 31.6%. The follow-up period was from 6 months to 6 years. All of the 19 patients were alive except 1 who was lost to follow-up after 1. 5 years. There was no recurrence nor new-onset diabetes mellitus. Conclusions Middle pancreatectomy was a proper operative approach for benign or low-malignant tumors located in the neck or the body of the pancreas. This pancreatectomy may preserve endocrine and exocrine function, and decrease the risk of postoperative new-onset diabetes mellitns.