CAJ | 학술논문

目的：对比保留幽门胰十二指肠切除术（PPPD）与传统胰十二指肠切除术（PD）两种手术的术中和术后情况，分析保留幽门胰十二指肠切除术的临床疗效。方法回顾性分析重庆市第三人民医院2010年1月至2013年12月，47例接受胰十二指肠切除术的壶腹周围癌和胰头癌患者的病历资料，根据手术方式的不同，分为PPPD组20例，PD组27例，比较两组患者的术中和术后情况。结果PPPD组患者手术时间明显低于PD组（P＜0．05）；PPPD组术后并发症发生率、术后感染率明显低于PD组（P＜0．05），其中胰漏、胆漏、胃肠漏、术后出血与PD组比较差异无统计学意义；两组患者病死率、术后胃排空延迟发生率差异无统计学意义（P＞0．05）。结论PPPD术式具有缩短手术时间、术后患者恢复快、并发症发生率低、住院时间短的优点，有助于迅速改善患者的营养状态，提高患者的术后生活质量，在治疗胰头癌及壶腹部周围癌具有广阔的应用前景。
목적：대비보류유문이십이지장절제술（PPPD）여전통이십이지장절제술（PD）량충수술적술중화술후정황，분석보류유문이십이지장절제술적림상료효。방법회고성분석중경시제삼인민의원2010년1월지2013년12월，47례접수이십이지장절제술적호복주위암화이두암환자적병력자료，근거수술방식적불동，분위PPPD조20례，PD조27례，비교량조환자적술중화술후정황。결과PPPD조환자수술시간명현저우PD조（P＜0．05）；PPPD조술후병발증발생솔、술후감염솔명현저우PD조（P＜0．05），기중이루、담루、위장루、술후출혈여PD조비교차이무통계학의의；량조환자병사솔、술후위배공연지발생솔차이무통계학의의（P＞0．05）。결론PPPD술식구유축단수술시간、술후환자회복쾌、병발증발생솔저、주원시간단적우점，유조우신속개선환자적영양상태，제고환자적술후생활질량，재치료이두암급호복부주위암구유엄활적응용전경。
Objective To compare the operation situation of pancreatico duodenectomy (PD) and pylorus‐preserving pancreatico duodenectomy (PPPD) ,and analyze the clinical efficacy of PPPD .Methods Data of 47 patients with periampullary carcinoma and pancreatic head carcinoma underwent pancreatico duodenectomy from January 2010 to December 2013 were retrospectively analyzed and divided into PPPD group (20 cases) and PD group (27 cases) according to different surgery method .Then compare the situa‐tion of intra‐operative and post‐operative situation in two groups of patients .Results The operation time of PPPD group was sig‐nificantly lower than that of PD group (P<0 .05);the incidence of postoperative complication rate of PPPD group was obviously lower than PD group (P< 0 .05);and postoperative infection rate of PPPD group was significantly lower than PD group (P<0 .05);there was no significant difference between two groups in pancreatic leakage ,bile leakage ,gastrointestinal leakage ,post oper‐ative bleeding ,mortality and the incidence of delayed gastric emptying after surgery (P>0 .05) .Conclusion PPPD operation could shorten the operation time ,promote post‐operative recovery ,lower complication rates and shorten hospitalization time ,and could al‐so help to improve the nutritional status of patients ,improve the postoperative quality of life of patients ,thus it should be further promoted .