保留十二指肠的胰头切除术治疗胰头部良性肿瘤2例报告并国内文献复习

Duodenum-preserving pancreatic head resection for benign tumors of the pancreatic head: report of two cases and domestic literature review

摘要:

目的：探讨保留十二指肠的胰头切除术（DPPHR）治疗胰头部良性肿瘤的价值。 方法：报告中国医科大学附属第一医院于2011年度实施2例DPPHR的临床资料，并结合国内近10年中9篇文献报道共66例DPPHR的资料，对所有68例DPPHR的并发症及手术疗效进行回顾性分析。 结果：68例中13例（19.2%）发生术后并发症，其中胰瘘10例（14.7%），十二指肠瘘1例（1.5%），胃瘫1例（1.5%），胆系感染1例（1.5%），均非手术治疗治愈。住院时间11~57 d，平均17 d，无住院期间病死病例。有随访资料44例，随访时间3个月至6年，均无复发。 结论：DPPHR是治疗胰头部良性肿瘤安全、有效的术式。

Abstract:

Objective: To analyze the value of duodenum-preserving pancreatic head resection (DPPHR) for benign tumors of the pancreatic head. Methods: The clinical data of two DPPHR cases performed in the First Affiliated Hospital of China Medical University in the year 2011 were presented. Together with the data of 66 DPPHR cases described in 9 literature reports over the recent 10 years in China, the complications and surgical efficacy of all the 68 DPPHR cases were retrospectively analyzed. Results: Of the 68 patients, postoperative complications occurred in 13 cases (19.2%), which comprised pancreatic fistula in 10 cases (14.7%), duodenal fistula in 1 case (1.5%), gastroparesis in 1 case (1.5%), and biliary infection in 1 case (1.5%), and all of them were successfully treated by non-surgical treatment. The length of hospital stay ranged from 11 to 57 d with average of 17 d, and no death occurred during hospitalization. Follow-up data were available in 44 cases with the follow-up period of 3 months to 6 years, and no recurrence occurred in any of them. Conclusion: DPPHR is a safe and effective treatment method for benign tumors in the head of the pancreas.