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目的 :探讨胰十二指肠切除术 ( pancreaticoduodenectomy ,PD)术前胆汁引流 (PBD)减轻梗阻性黄疸对于手术后结果的影响。方法 :回顾性分析了我院自 1991年以来收治的胰头及总胆管下段恶性肿瘤手术治疗病例 89例 ,其中 3 5例患者PD术前进行胆汁引流减黄手术 ,5 4例患者未行PD术前减黄手术 ,从术前血清胆红素水平、术中胆汁培养及术后并发症等情况进行比较。结果 :PD术前减黄组由于PBD引起胆汁性腹膜炎 2例 ,胆道感染 1例。术前减黄组PD术中胆汁培养阳性 16例 ,明显高于未减黄组3例 (P <0 .0 5 )。减黄组PD术后总并发症发生率 ( 7/ 3 5 )明显低于未减黄组 ( 2 8/ 5 4) (P <0 .0 5 )。结论 :PD术前减黄虽然存在着一定的并发症 ,但减黄确能降低PD术后并发症的发生
Objective: To investigate the effect of preoperative pancreaticoduodenectomy (PDD) on biliary drainage (PBD) to reduce obstructive jaundice after operation. Methods: A retrospective analysis of our hospital since 1991, the treatment of pancreatic cancer and cholecystolithiasis lower malignant tumor surgical treatment of 89 cases, of which 35 cases of patients with PD preoperative biliary drainage and yellowing surgery, 54 patients without PD Preoperative reduction of yellow surgery, preoperative serum bilirubin levels, intraoperative bile culture and postoperative complications were compared. Results: There were 2 cases of biliary peritonitis and 1 case of biliary tract infection due to PBD. Sixteen cases were positive for bile culture in PD group before operation, which was significantly higher than that in the control group (P <0.05). The incidence of postoperative complications in PD group (7/35) was significantly lower than that in non-HD group (28/54) (P <0.05). Conclusion: There is a certain complication of yellowing before PD, but yellowing can reduce the incidence of complications after PD