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本文总结28年来采取胰十二指肠切除治疗的胰头及壶腹周围肿瘤等病人49例。胰头癌和壶腹癌术后生存最长者分别为8.5年和18年。本文总结了胰管处理方式、血清胆红质与并发症的关系。胰管—空肠粘膜吻合,胰瘘发生率为5.6%;胰腺断端空肠内套入,胰瘘发生率13.3%,血清胆红质高于10mg/dl,并发症发生率61.5%,低于10mg/dl,并发症发生率25%手术死亡率为6.1%。预防、减少和妥善处理术后并发症是降低手术死亡率的关键。
This article summarizes 49 cases of pancreatic head and periampullary tumors treated with pancreatoduodenectomy for 28 years. The longest survival rates for pancreatic cancer and ampullary carcinoma were 8.5 years and 18 years, respectively. This article summarizes the relationship between pancreatic duct management, serum bilirubin and complications. Pancreatic duct-jejunal mucosa anastomosis, the incidence of pancreatic fistula was 5.6%; pancreatic ends were entrapped in the jejunum, the incidence of pancreatic fistula was 13.3%, serum bilirubin was higher than 10mg/dl, the incidence of complications was 61.5%, less than 10mg /dl, complication rate 25% operative mortality was 6.1%. Preventing, reducing and properly treating postoperative complications is the key to reducing operative mortality.