改良的保留十二指肠胰头全切除术

目的总结分析我中心近年来对胰头部良性病变实施改良的保留十二指肠胰头全切除术的效果。方法回顾性分析我中心2004年6月至2008年6月实施了改良的保留十二指肠胰头切除术的27例患者的临床资料。对该术式的手术方式，并发症及术后近期生存质量进行评价。结果患者手术死亡0例，术后发生胰瘘2例，十二指肠瘘1例，胆瘘1例，其并发症发生率为14．81％，平均手术时间约4h，术后平均住院日为16d。结论保留十二指肠的胰头切除术通过保留胰十二指肠上动脉后支及其血管弓，仅在十二指肠乳头及胆总管后壁残留少许胰腺组织，手术切除彻底，术后并发症发生率低，手术操作简便，患者术后恢复快，住院时间短。该改良术式可以作为治疗胰头部良性病变的重要术式。

Modified duodeum-preserving resection of the head of the pancreas

Objective To determine the effect of duodenum - preserving resection of the head of the pancreas for benign lesions in the head of the pancreas. Methods We retrospectively analyzed 27 patients treated from June 2004 to June 2008 at this hospital, and evaluated the operation techniques, complications, and the quality of postoperative life of the patients. Results There was no operative mortality; pancreatic fistula was seen in 2 patients, duodenal fistula in 1, and biliary fistula in 1. The incidence of complications was 14.81%, the mean operation time was 4 hours, and the mean postoperative length of hospital stay was 16 days. Conclusions The operation can protect the blood supply of the duodenum by preserving the pos- terior superior pancrcaticoduodenal artery and the posterior pancreaticoduodenal arterial arcade. A little bit of pancreas attached to the duodenal papilla and the common bile duct remains. The operation is simpler, the incidence of complications is lower, and the postoperative recovery is quicker. The modified operation is a vital technique for benign lesions in the head of the pancreas.