CAJ | 학술논문

目的探讨胰腺中段切除术在胰腺颈体部良性肿瘤中的临床实用价值.方法对2005年11月至2009年6月期间收治的胰腺颈体部良性肿瘤并施行胰腺中段切除术的15例病例进行回顾性分析,男性3例,女性12例,年龄30～55岁,平均45岁.其中因上腹部胀痛不适入院4例,其余11例均为常规体检行腹部彩色超声检查发现.结果本组患者无围手术期死亡.15例患者均行胰腺中段切除,其中14例行胰头断端闭锁、胰尾空肠吻术(单吻合术),1例行胰腺两断端空肠"Ω"吻合(双吻合术).术后病理检查结果显示,胰腺实性假乳头状瘤1例,无功能性胰岛细胞瘤3例,胰腺囊腺瘤11例.术后发生胰瘘3例,均在3个月内自行愈合.所有患者均获得随访,随访时间2～45个月,15例患者无死亡,无新发糖尿病,无肿瘤再发,无胰腺假性囊肿形成.结论胰腺中段切除术治疗胰腺颈体部良性肿瘤临床效果确切,对患者内、外分泌功能影响小,胰瘘发生率高于胰头十二指肠切除术,只要通畅引流,多能自行愈合.
목적 탐토이선중단절제술재이선경체부량성종류중적림상실용개치.방법 대2005년11월지2009년6월기간수치적이선경체부량성종류병시행이선중단절제술적15례병례진행회고성분석,남성3례,녀성12례,년령30～55세,평균45세.기중인상복부창통불괄입원4례,기여11례균위상규체검행복부채색초성검사발현.결과 본조환자무위수술기사망.15례환자균행이선중단절제,기중14례행이두단단폐쇄、이미공장문술(단문합술),1례행이선량단단공장"Ω"문합(쌍문합술).술후병리검사결과현시,이선실성가유두상류1례,무공능성이도세포류3례,이선낭선류11례.술후발생이루3례,균재3개월내자행유합.소유환자균획득수방,수방시간2～45개월,15례환자무사망,무신발당뇨병,무종류재발,무이선가성낭종형성.결론 이선중단절제술치료이선경체부량성종류림상효과학절,대환자내、외분비공능영향소,이루발생솔고우이두십이지장절제술,지요통창인류,다능자행유합.
Objective To study the clinical application value of middle segment pancreatectomy in the treatment of benign tumors of the amphi-neck of the pancreas. Methods Fifteen cases were retrospectively analyzed treated from November 2005 to June 2009. There were 3 male and 12 female aging from 30 to 50 years. They all received middle segment pancreatectomy for benign tumors of the amphi-neck of the pancreas. Results There was no death during perioperative period. All the 15 patients received middle segment pancreatectomy. Fourteen of them received the closure of broken ends of pancreatic head,pancreaticojeunostomy (mono-anastomosis) and the rest one received dipl-anastomosis. Postoperative pathology showed that in the 15 patients, 1 got solid-pseudopapillary tumor of the pancreas, 3 got nonfunctional islet cell tumor, 11 got cystadenoma of pancreas. Three of them got pancreatic fistula and were self cured in 3 months. Follow-up visits to all the patients kept in the following 2 to 45 months. There was no death. No patients got new-onset diabetes and pancreatic pseudocyst. And their tumors were not relapsed.Conclusions There is an exact therapeutic effect of middle segment pancreatectomy for benign tumors of the amphi-neck of the pancreas. The treatment has little function damage to patients' endocrine and external secretion. The incidence rate of pancreatic fistula in middle segment pancreatectomy is higher than that in pancreaticoduodenectomy. As long as the drainage is kept unobstructed, most of the pancreatic fistula can be self cured.