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目的研究胰头十二指肠第二段切除术的临床应用。方法对4例胰头十二指肠第二段切除术患者的临床资料进行回顾性分析。结果本组包括3例良性和1例低度恶性病变。平均手术时间417min,术中平均输血量533ml,平均住院时间28.6d。无手术死亡和近期严重并发症,仅出现1例术后胃排空延迟。随访6～36个月,4例患者现均存活。出现轻度脂肪泻伴消瘦1例;无新发糖尿病和严重的胃肠道症状。1例潜在恶性十二指肠间质瘤患者,随访26个月无局部复发或转移征象。结论对于壶腹周围的良性和某些低度恶性病变,胰头十二指肠第二段切除术是一种较为理想的治疗手段。
Objective To study the clinical application of the second stage pancreatoduodenectomy. Methods The clinical data of 4 cases of second stage pancreatoduodenectomy were analyzed retrospectively. Results This group includes 3 cases of benign and 1 case of low grade malignant lesions. The average operation time was 417min. The mean intraoperative blood transfusion was 533ml and the average hospitalization time was 28.6 days. No surgical death and recent serious complications, only one case of postoperative delayed gastric emptying. All the patients survived 6 to 36 months after follow-up. A case of mild steatorrhea with weight loss; no new-onset diabetes and severe gastrointestinal symptoms. A case of potentially malignant duodenal stromal tumors, 26 months follow-up no signs of local recurrence or metastasis. Conclusion For ampullary benign and some low-grade malignant lesions, the second pancreatoduodenectomy is a more ideal treatment.