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1935年Whipple报告第一例胰十二指肠切除术(Whipple手术).由于该手术死亡率高,对胰腺癌病人生存期延长不明显,1960～70年代胰十二指肠切除术对治疗胰腺癌的价值受到非议.本文回顾18年来Johns Hopkins医院行胰十二指肠切除术的经验.1969～1986年间共88名病人由于壶腹周围癌接受Whipple手术,其中胰头癌50例,壶腹癌19例,下段胆管癌10例,十二指肠癌9例.男性49例,女性39例,平均年龄58.4岁.黄疸是最主要的症状,体重下降及上腹不适亦常见.住院前症状平均已有8.1±1.2周.体检发现有肝大,胆囊大,腹块等,一部分病人有糖尿病.实验室检查往往AKP及GOT增高.为了了解近年来Whipple手术后并发病发生率及死亡率的变化趋势,将88例病人分成两组:1969～1980年手术的41例病人和1981～1986年手术的47例病人.两组病人临床资料无明显差别.88例
In 1935 Whipple reported the first case of pancreatoduodenectomy (Whipple surgery). Due to the high mortality rate of this operation, the survival of pancreatic cancer patients did not extend significantly, pancreaticoduodenectomy in the 1960-70s treatment of pancreas The value of cancer has been criticized. This article reviews the experience of pancreatoduodenectomy performed by Johns Hopkins Hospital for 18 years. From 1969 to 1986, a total of 88 patients received Whipple surgery for peripheral periampullary cancer, including 50 cases of pancreatic cancer and ampulla. There were 19 cases of cancer, 10 cases of lower bile duct cancer, and 9 cases of duodenal cancer. There were 49 males and 39 females with an average age of 58.4 years. Jaundice was the main symptom. Weight loss and epigastric discomfort were also common. Pre-hospital symptoms The average has been 8.1 ± 1.2 weeks. Physical examination found liver, gallbladder, abdominal mass, etc., some patients have diabetes. Laboratory tests are often increased AKP and GOT. In order to understand the incidence of complications and mortality after Whipple surgery in recent years With regard to the trend of change, 88 patients were divided into two groups: 41 patients undergoing surgery from 1969 to 1980 and 47 patients undergoing surgery from 1981 to 1986. There was no significant difference in clinical data between the two groups. 88 patients