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目的 总结胰十二指肠切除术的经验教训。方法 对 1961年 6月至 1999年 6月收治的 2 3 2例行胰十二指肠切除术(PD)的胰头及壶腹部肿瘤患者的病例资料 ,进行回顾性分析。结果 术后近期并发症的发生率为 3 5 .8% (83 /2 3 2 ) ,手术死亡率为6.9% (16/2 3 2 )。以 1986年为界 ,将PD手术患者分为 2个阶段进行对照 ,手术并发症从第 1个阶段的 45 .3 % (3 4 /75 )下降至第 2个阶段的 3 1.2 % (49/15 7,P <0 .0 5 ) ,手术死亡率从第 1个阶段的 14 .7% (11/75 )下降至第 2个阶段的 3 .2 % (5 /15 7,P <0 .0 1)。结论 配备有丰富经验的专科医生和完善的外科操作技术是降低手术并发症和手术死亡率的关键。
Objective To summarize the lessons learned from pancreatoduodenectomy. Methods The data of 236 patients with pancreatic head and ampullary tumor undergoing pancreaticoduodenectomy (PD) from June 1961 to June 1999 were analyzed retrospectively. Results The incidence of postoperative complications was 35.8% (83/223). The operative mortality was 6.9% (16/2 3 2 ). With 1986 as the boundary, PD patients were divided into 2 phases for comparison. The surgical complications decreased from 45.3% (3 4 /75) in the first phase to 3 1.2% in the second phase (49/ 15, 7, P <0.05, the operative mortality rate decreased from 14.7% (11/75) in the first phase to 3.2% in the second phase (5/15 7, P <0. 0 1). Conclusions Specialist surgeons with extensive experience and sound surgical techniques are key to reducing surgical complications and operative mortality.