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目的探讨胰腺中段切除术在治疗胰腺颈体部良性肿瘤中的临床意义。方法回顾性分析笔者所在医院胰胆外科2007年2月1日至2012年2月1日期间行胰腺中段切除术的29例患者的临床资料。结果 29例病例无围手术期死亡,手术时间为(165±45)min(125~270 min);术中出血量为(173±88)mL(50~450 mL);术后病理报告均为良性肿瘤。术后出现不同程度胰瘘10例(A级9例,B级1例),均经非手术治疗治愈;术后出现胰腺远侧断面活动性出血1例,经二次手术止血,效果仍欠佳,遂行第三次手术,剖腹探查见胰肠吻合口漏、胰肠吻合口出血,故行胰体尾加脾切除术,术后恢复良好,痊愈出院。29例患者中获随访21例,随访时间3个月~4年,平均16个月,均未出现糖尿病等相关并发症。结论胰腺中段切除术是治疗胰腺颈部及体部良性肿瘤及低度恶性肿瘤的一种合理术式,可较好地保存术后胰腺的内、外分泌功能,提高患者的生活质量。
Objective To investigate the clinical significance of middle pancreatectomy in the treatment of benign tumors of the neck of pancreas. Methods Retrospective analysis of the clinical data of 29 patients undergoing pancreatectomy from January 1, 2007 to February 1, 2012 in our hospital. Results There were no perioperative deaths in 29 patients. The operative time was (165 ± 45) min (125-270 min) and the blood loss was (173 ± 88) mL (50-450 mL). The postoperative pathological reports were Benign tumor. There were 10 cases of pancreatic fistula (9 cases of A grade and 1 case of B grade) after operation. All of them were cured by non-surgical treatment. One case of active bleeding in the distal part of pancreas occurred after operation, Good, the implementation of the third surgery, laparotomy see pancreatic anastomosis leakage, pancreatic anastomosis bleeding, so the body of the pancreas and spleen plus splenectomy, postoperative recovery was good, discharged. Among the 29 patients, 21 were followed up for 3 months to 4 years with an average of 16 months. No complications such as diabetes were found. Conclusions Pancreatic resection is a reasonable technique for the treatment of benign and malignant tumors of the neck and body of the pancreas. It can well preserve the exocrine function of the pancreas and improve the quality of life of patients.