胰头十二指肠切除术68例体会

目的 总结胰头十二指肠切除术的经验。方法 回顾性总结12年间行PDR68例。其中13例采用保留幽门的胰头十二指肠切除术。消化道重建均采用Child胰管空肠吻合胰残端套入法。结果 近期死亡3例，死亡率4．41％。胰瘘2例，占2．94％。9例失访，56例获得随访者；1年以上存活率为64．71％，3年以上存活率为14．71％，5年以上存活率为4．41％。结论 固定专业手术人员，固定术式、严格按规范方法操作、充分有效的引流和加强围手术期的处理均是减少并发症，提高治愈率和延长存活率的重要措施。

PANCREATIC DUODENUM REMOVAL IN 68 CASES

Objective To summarize the experience in pancreatic duodenum removal (PDR) .Methods PDR in 68 cases treated in the past 12 years was analyzed retrospectively . 13 cases of them received pylorus- preserved pancreatic duodectomy(PPPD ). Digestive tracts were reconstructed through pancreaticojejunostomy and pancreatic stump cannulation .Results In these cases, 3 died postoperatively(4.41%) , and 2(2.94%)suffered from pancreatic fistula postopreatively.According to the follow-up surveys ,64.71% of 56 cases survived for more than 1 year , 14.71% for more than 3 years and 4.41% for more than 5 years.Conclusion Specified surgeons,strict operative program,effective drainage and strengthening of clinical handling can reduce complications and improve the curative and survival rates.