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目的探讨胰腺专业组与非专业组胰十二指肠切除术(PD)有无差别。方法回顾性分析我院自1986年成立胰腺专业组以来至2003年276例胰十二指肠切除术资料,其中专业组行PD197例,非专业组行PD79例。结果专业组与非专业组手术切除率、切缘阳性率、胰瘘发生率、平均切除肿瘤大小、平均清除淋巴结数、平均术中输血量、平均手术时间、术后平均住院时间、术后平均生存期、手术死亡率分别为42.7%、8.63%、2.54%、3.11 cm、9.019、80 ml、6.4 h、17.1 d、25.7个月、1.52%和28.4%、20.25%、10.12%、2.77 cm、5.451、340 ml、5.46 h、23.6 d、17.8个月、8.86%,有显著性差异(P<0.05或P<0.01),而在胆瘘、出血、胃潴留、感染方面无显著性差异。结论宜成立胰腺诊治中心或专业组,集中收治胰腺病人,以提高手术安全性和规范性。主张根治术和扩大根治术,提高疗效。
Objective To investigate whether there is any difference in pancreaticoduodenectomy (PD) between pancreas and non-specialty groups. Methods The data of 276 pancreaticoduodenectomy cases in our hospital since the establishment of pancreas specialized group in 1986 and 2003 were analyzed retrospectively. Among them, there were PD197 cases in professional group and PD79 cases in non-professional group. Results The rates of resection margin, positive margins, the incidence of pancreatic fistula, the average tumor size, the number of clear lymph nodes, the mean intraoperative blood transfusion, the average operation time, the average postoperative hospital stay, the postoperative average Survival and operative mortality were 42.7%, 8.63%, 2.54%, 3.11 cm, 9.019,80 ml, 6.4 h, 17.1 d, 25.7 months, 1.52% and 28.4%, 20.25%, 10.12%, 2.77 cm, 5.451,340 ml, 5.46 h, 23.6 d, 17.8 months and 8.86%, respectively (P <0.05 or P <0.01). There was no significant difference in biliary fistula, bleeding, gastric retention and infection. Conclusions Pancreas diagnosis and treatment center or professional group should be set up to focus on the treatment of pancreatic patients to improve the safety and normative operation. Advocating radical surgery and expanding radical surgery to improve efficacy.