胰头肿块型慢性胰腺炎18例外科治疗体会

【摘要】〓目的〓探讨胰头肿块型慢性胰腺炎的外科治疗效果。方法〓回顾性分析1999年1月~2013年12月15年间经手术治疗的18例胰头肿块型慢性胰腺炎患者的临床资料。18例中4例合并胰管结石,5例合并胰腺囊肿;10例行胰十二指肠切除术,4例行胰管空肠Roux-y吻合术,2例行胰腺囊肿空肠Roux-y吻合术,1例行胆总管空肠Roux-y吻合术,1例同时行胰肠吻合和胃空肠吻合术。结果〓17例完成手术,1例损伤肠系膜上静脉大出血术中死亡。术后出现胸腔积液2例,切口裂开1例。获随访13例,行胰十二指肠切除术8例疼痛完全消失;胰肠或胆肠吻合4例疼痛部分缓解;1例顽固性疼痛,反复住院治疗。结论〓外科手术是胰头肿块型慢性胰腺炎的有效治疗方式,胰十二指肠切除术效果显著。

Experience in the surgical treatment for pancreatic head mass of chronic pancreatitis in 18 cases

Objective To investigate the effect of surgical treatment of chronic pancreatitis with mass in the head of pancreas. Methods Tile clinical data of 18 cases of chronic pancreatitis with mass in head between January 1999 and December 2013 were retrospectively analyzed. Of 18 cases, 4 cases were associated with pancreatic duct stones, 5 cases with pancreatic cyst, and pancreatoduodene- ctomy was performed in 10 cases, pancreato-jejunal Roux-y anastomosis in 4 cases, pancreatic cyst jejunum Roux-y anastomosis in 2 cases, bile duct jejunum Roux-y anastomosis in one cases, pancreaticojejunostomy combined with gastrojejunostomy was in one case. Results Seventeen patients were completed the operation, one case died from superior mesenteric venous bleeding. Pleural effusion after operation occurred in 2 cases, wound dehiscence was in one cases. 13 cases were followed up for 6 months to 10 years. The pain completely disappeared in 8 cases with pancreatoduodenectomy. Tile pain eased obviously in 4 cases with intestine and pancreas or biliary enteric anastomosis. Pain in one cases failed to relieve and had to repeated hospitalization due to intractable pain. Conclusion In our study, surgical operation was the effective treatment of chronic pancreatitis with mass in head, especially pancreatic resection.