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目的:回顾分析胰头或钩突分支胰管型导管内乳头状黏液性瘤(IPMN)行局部剜除术(EN)的病人与行胰十二指肠切除术(PD)的病人进行比较,观察行两者的围手术期效果。方法:对上海第六人民医院1995年6月至2010年6月共132例胰头或钩突IPMN病人进行回顾性分析,局部剜除术(EN)组32例,胰十二指肠切除术(PD)组100例,通过X线检查发现其中19例适合行EN。结果:EN组与PD组相比,手术时间缩短(P<0.05),出血量减少(P<0.05)。然而两组病人总胰漏发生率与C级胰漏率无统计学差异。结论:对于胰头或钩突分支胰管型IPMN病人行EN与PD相比,EN出血少、手术时间短,而并发症发生率、死亡率及术后住院天数两者无统计学差异。因此,对于单病灶分支胰管型IPMN,EN是一种更合适和有效的手术方式。
OBJECTIVE: To retrospectively compare patients undergoing pancreaticoduodenal or intraocular papillary duodenal ductal papillary mucinous neoplasm (IPMN) with partial enucleation (EN) with pancreaticoduodenectomy (PD) Observe the perioperative effect of both lines. Methods: A retrospective analysis was performed on 132 patients with IPMN of head of pancreas or uncinate disease from June 1995 to June 2010 in Shanghai Sixth People’s Hospital. 32 patients underwent partial enucleation (EN), pancreaticoduodenectomy (PD) group of 100 cases, by X-ray examination found that 19 cases were eligible for EN. Results: Compared with PD group, the operative time was shorter (P <0.05) and the amount of bleeding was decreased (P <0.05). However, there was no significant difference between the two groups in the incidence of total pancreatic leakage and grade C pancreatic leakage. CONCLUSIONS: EN has less bleeding and shorter operative time compared with PD in pancreaticobranchial or uncinate pancreatic ductal IPMN patients. There is no significant difference in the complication rate, mortality rate, and postoperative hospital stay between EN and PD. Therefore, the single-branch pancreatic duct type IPMN, EN is a more appropriate and effective surgical approach.