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自1935年whipple首先采用胰十二指肠切除术治疗壶腹周围癌获得成功以来,经过60年的演变,至今已成为治疗壶腹周围癌的唯一有效标准术式,但由于胰十二指肠切除术的操作步骤多,手术时间长,技术难度大,合并症多,所以手术死亡率高,随着科学技术的不断进步,术式的进一步完善,手术死亡率已有明显下降,并发症虽有下降趋势,但某些严重并发症仍是围手术期处理的重要课题,也是直接影响疗效与术后生存率的关键问题。 1 术前准备需做胰十二指肠切除术的病例,多为外科阻塞性
Since the success of pancreatoduodenectomy for periampullary cancer in 1935, whipple has been the only effective standard treatment for periampullary cancer after 60 years of evolution, but due to the pancreatic duodenum The resection has many operation steps, long operation time, technical difficulty, and complications, so the operative mortality is high. With the continuous progress of science and technology, further improvement of the surgical method, the surgical mortality has decreased significantly, although the complications There is a downward trend, but some serious complications are still an important issue in perioperative management, and it is also a key issue that directly affects the efficacy and postoperative survival rate. 1 Preparation for pancreatoduodenectomy before surgery, mostly surgical obstructive