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目的:探讨胰腺中段切除术(MP)治疗良性和低度恶性胰腺颈体部肿瘤的疗效。方法:回顾性分析2005年8月—2013年2月收治的32例胰腺颈体部良性和低度恶性肿瘤行MP患者资料(MP组),并与同期因良性和低度恶性胰腺肿瘤行胰十二指肠切除术(PD)的30例(PD组)和行胰体尾切除术(DP)的36例(DP组)患者资料进行比较。结果:MP组、PD组、DP组平均手术时间分别为(180.8±56.4)、(279.6±79.2)、(190.4±62.3)min;平均术中出血量分别为(196.5±185.7)、(482.6±288.5)、(320.7±240.3)mL;胃肠道功能恢复时间分别为(3.6±1.6)、(5.2±2.3)、(4.1±1.9)d;新增糖尿病例数分别为1、5、9例;术后需要补充胰酶例数分别为0、8、5例,以上指标3组间差异均有统计学意义(均P<0.05)。MP组、PD组、DP组术后胰瘘发生率(18.8%、12.5%、25.0%)以及其他围手术期指标差异均无统计学意义(均P>0.05)。平均随访38个月,各组均无肿瘤复发。结论:MP治疗良性或低度恶性胰腺颈体部肿瘤是一项合理的技术,能更好地保护胰腺外分泌和内分泌功能。
Objective: To investigate the curative effect of mid-pancreatectomy (MP) on benign and low-grade pancreatic and cervical body tumors. Methods: A retrospective analysis was performed on 32 MP patients with benign and low-grade cancers in the pancreas of the neck from August 2005 to February 2013. The patients with MP were treated with pancreatic Thirty patients with PD (PD group) and 36 patients (DP group) undergoing pancreaticotomosicotomy (DP) were compared. Results The average operative time in MP group, PD group and DP group were (180.8 ± 56.4), (279.6 ± 79.2) and (190.4 ± 62.3) min, respectively. The mean intraoperative blood loss were (196.5 ± 185.7) and (482.6 ± 288.5) and (320.7 ± 240.3) mL, respectively. The recovery time of gastrointestinal function was (3.6 ± 1.6), (5.2 ± 2.3) and (4.1 ± 1.9) days, respectively. . There were 0, 8 and 5 cases of pancreatic enzyme supplementation after operation, respectively. There was significant difference among the above three indexes (all P <0.05). The incidences of postoperative pancreatic fistula (18.8%, 12.5%, 25.0%) in MP group, PD group and DP group were not significantly different from those of other perioperative groups (all P> 0.05). The average follow-up of 38 months, no tumor recurrence in each group. Conclusion: MP is a reasonable technique to treat pancreatic exocrine and endocrine functions in the treatment of benign or low-grade pancreatic and cervical tumors.