中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (09): 777-779.

• 论著 • 上一篇    下一篇

胰腺中段节段性切除术（附40例报告）

陈    实 ，刘国华 ，邓侠兴 ，沈柏用， 彭承宏   

  1. 上海交通大学医学院附属瑞金医院普外科，上海200025
  • 出版日期:2010-09-01 发布日期:2010-09-01

  • Online:2010-09-01 Published:2010-09-01

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摘要：

目的    总结胰腺中段节段性切除术的临床经验。方法    回顾性分析上海交通大学医学院附属瑞金医院2003年4月至2009年12月共40例行胰中段节段性切除的病例资料，对术前、术中情况及术后并发症和预后进行统计分析。结果    手术时间平均为 225min，术中出血平均为295mL，切除胰腺长度平均为44mm。术后病理报告4例为恶性肿瘤，余为良性。术后平均住院时间为29d。1例术后出现腹腔内出血，经过输血、止血等保守治疗后，成功治愈。有17例病人术后出现胰瘘。术后平均随访时间31个月（4个月至6年），2例死于胰腺癌转移后多器官功能衰竭。出现新发糖尿病1例。结论    对于胰颈部或体部的胰腺良性、低度恶性肿瘤，在具有手术指征情况下，胰腺中段切除是合理的手术方式。

关键词: 胰腺中段切除, 胰瘘, 内外分泌功能

Abstract:

Clinically application of middle segmental pancreatectomy :analysis of 40 cases        CHEN Shi, LIU Guo-hua,DENG Xia-xing,et al. Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai200025,China
Corresponding author: PENG Cheng-hong, E-mail: chhpeng@188.com
Abstract    Obiective    To summarize the experiences of middle pancreatectomy and evaluate the perioperative and long-term results．Methods    The data of 40 cases underoing middle segmental pancreatectomy were reviewed retrospectively to analyze the preoperative and operation situation and postoperative complication with prognosis．Results    Mean operative time was 225min，mean blood loss was 295mL，mean length of resected pancreas was 44 mm . Mean postoperative time in hospital was 29d. Three patient with malignant tumor,others with benign neoplasms were included. One patient with bleeding after operation was treated in haemostasis and transfution.Complication after operation was pancreatic fistula（17cases）．The mean time of follow—up was 31 months(4 months—6 years).Two patient was died of multiple organs failure for carcinomatous matastsis, the others were alive with a new diabetic．Conclusion Middle segmental pancreatectomy is a reasonable technique that is indicated for selected patients with benign or low malignant tumors in the neck and body of the pancreas.

Key words: middle segmental pancreatectomy, pancreatic fistula, endocrine and exocrine function