恶性肿瘤时保留幽门的十二指肠胰头切除术的现代适应证

• 作 者: H.B.Reith W.Kozuschek L.W.Traverso 陈刚
• 机 构: Chirurgische Universittsklinik Bochum,Knappschaftskrankenhaus,In der Schornau 23,D-44892 Bochum,Germ
• 出 处: The Chinese-German Journal of Clinical Oncology
• 发表日期: 1999年02期
• 关键词: 切除术 正常体重 Whipple 胃肠吻合口 慢性胰腺炎 肠道功能障碍 幽门部 倾倒综合征 外科医生 生活质量

Whipple手术会引起肠道功能障碍,如倾倒综合征、腹泻、消化不良及胃肠吻合口溃疡形成。对病人最大的问题是体重减轻和恢复正常体重的能力削弱。此外,肿瘤手术的采用仅由外科医生决定,而无活检判定是否恶性肿瘤,因而增加了手术的死亡率和发病率。 保留幽门的改良手术是期望病人能够恢复到正常体重并保持良好的远期状况和生活质量。现在其适应证是慢性胰腺炎和恶性肿瘤。

Whipple surgery can cause intestinal dysfunction, such as dumping syndrome, diarrhea, dyspepsia, and gastrointestinal anastomotic ulcer formation. The biggest problem for patients is the loss of weight and ability to restore normal weight. In addition, the use of oncological surgery is only determined by the surgeon, and no biopsy is used to determine whether or not a malignancy has occurred, thereby increasing the mortality and morbidity of the operation. An improved procedure to preserve the pylorus is to expect the patient to return to normal weight and maintain good long-term conditions and quality of life. Its indications are now chronic pancreatitis and malignancy.