胰十二指肠切除术210例临床分析

目的 探讨胰十二指肠切除(PD)术后并发症及死亡率发生、预防及处理的问题。方法 回顾性分析1977～2002年间210例胰十二指肠切除术的并发癌及死亡率，根据手术年代分为三组，比较各组的术后并发症和死亡率。结果 本组术后出现并发症72例(34．3%)，严重并发症55例(26．2％)，死亡17例(8．1％)；近2年的并发症发生率为17．5%，严重并发症发生率为14％，死亡率1．8％，均比以前明显下降。结论 PD术是需要经过一定时间外科训练才能完成的手术，手术经验、精细操作和围手术监护治疗是减少并发症及死亡率的关键。

Analysis of 210 cases receiving pancreatoduodenectomy

Objective To analyze the morbidity and mortality and evaluate the measures regarding prevention and treatment of complications after pancreatoduodenectomy (PD). Methods A total of 210 patients receiving PD in our hospital from 1997 to 2002 were divided into 3 groups based on the different time when they were subjected to the operation. The morbidity and mortality were compared among the 3 groups. Results Postoperative complication occurred in 72 patients (34.3%). Of these 72 patients,55 (26.2% of the total) had severe complications and 17 (8.1% of the total) died. The occurring rate of complications was 17.5%,occurring rate of severe complications 14% and postoperative mortality 1.8% in recent 2 years. They were significantly lower than those in the past. Conclusions PD is a procedure that only can be grasped by those surgeons who have gained a certain time of good surgical training. The operator's experience,refined operation and pre- and postoperative intensive care are very important for reducing occurring rate of postoperative complications and mortality.