改良Beger手术效果及并发症预防体会

目的 探讨改良Beger手术效果及并发症的预防措施.方法 回顾性分析2014年1月至2020年1月临沧市人民医院收治行手术治疗的31例慢性胰腺炎、胰头良性及低度恶性肿瘤患者的临床资料,其中胰头肿块型慢性胰腺炎26例,胰头囊肿合并胰管结石2例,胰头实性假乳头状瘤1例,导管内乳头状黏液性肿瘤1例,胰头浆液性囊腺瘤1例.手术...

Effect of modified Beger operation and prevention of postoperative complications

Objective To analyze the effect of modified Beger operation and prevention of postoperative complications. Methods A retrospective analysis was condueted in 31 patients with chronic pancreatitis, benign and low-grade malignant tumors of the head of pancreas who underwent surgical treatment in Lincang People’s Hospital from Jan. 2014 to Jan. 2020. Among 31 patients, 26 cases with mass type chronic pancreatitis in the head of pancreas, 2 cases with cyst of pancreatic head combined with pancreatic duct stones, 1 case with solid pseudopapillary tumor, 1 case with intraductal papillary mucinous tumor and 1 case with serous cystadenoma of the head of pancreas. All patients received modified Beger operation. Results After modified Beger operation, 4 cases (12.9%) developed short-term complications, including pancreatic leakage occured in 3 cases and bile leakage in 1 case. And 29 patients were followed-up for 6 months to 5 years, among them only 2 cases developed fatty diarrhea. No tumor or stone recurrence, no postoperative diabetes or reflux cholangitis. The preoperative and postoperative Izbicki pain score [(49.25±3.18) vs (12.21±1.34)], GLQI score [(62.13±3.36) vs (89.96±2.36)] and BMI [(29.23±3.57)kg/m² vs (34.31±3.56)kg/m² ] were all statistically different (P<0.05). Conclusion In order to ensure sufficient blood supply for duodenum and ampulla, the key measures to prevent the postoperative complications of modified Beger operation are to master the skilled technique of pancreatic neck transection and subtotal pancreatectomy. Modified Beger operation has advantages with small trauma and fewer postoperative complications, which can continuously relieve the pain and improve the life quality of patients with chronic pancreatitis for a long time.