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目的:探讨术前胆道引流(PBD)对胰十二指肠切除术(PD)疗效的影响。方法:回顾性分析湖南师范大学附属湘东医院2004~2010年136例行胰十二指肠切除术病例资料,根据有无行术前胆道引流(PBD)分为PBD组和非PBD组,统计分析两组手术时间、术中出血量、术前胆道引流效果、术后并发症情况。结果:PBD组与非PBD组术前平均胆红素水平比较差异无统计学意义(P>0.05),两组平均手术时间、术中平均失血量、术后单发症发生情况比较差异无统计学意义(P>0.05);PBD组胆道引流前、后胆红素水平差异有统计学意义(P<0.05);并发症总发生率比较,PBD组与非PBD组之间比较差异无统计学意义(P>0.05)。结论:梗阻性黄疸是影响行PD患者术后的重要危险因素。术前胆道引流对改善肝功能有一定的效果,但是对术后并发症发生率没有明显影响。目前早期行手术治疗对改善患者预后或许更有意义。
Objective: To investigate the effect of preoperative biliary drainage (PDD) on the efficacy of pancreaticoduodenectomy (PD). Methods: A retrospective analysis was performed on 136 cases of pancreatoduodenectomy in Xiangdong Hospital Affiliated to Hunan Normal University from 2004 to 2010. The data were divided into PBD group and non-PBD group according to the presence or absence of preoperative biliary drainage (PBD) The operation time, intraoperative blood loss, preoperative biliary drainage and postoperative complications were analyzed. Results: There was no significant difference in average preoperative bilirubin levels between PBD group and non-PBD group (P> 0.05). There was no statistical difference between the two groups in mean operative time, average intraoperative blood loss and postoperative morbidity (P> 0.05). The levels of bilirubin in PBD group before and after biliary drainage were significantly different (P <0.05). The complication rate was no significant difference between PBD group and non-PBD group Significance (P> 0.05). Conclusion: Obstructive jaundice is an important risk factor for postoperative PD patients. Preoperative biliary drainage to improve liver function have a certain effect, but no significant impact on the incidence of postoperative complications. At present, early surgical treatment may improve the prognosis of patients more meaningful.