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本文报告87例胰头、壶腹周围癌梗阻性黄疸病例,随机分为两组,一组行单纯黄疸内引流;另一组在黄疸内引流的同时行预防性胃空肠吻合。术后观察发现,两组病例的手术死亡率、住院时间基本相同;术后并发症黄疸内引流同时行预防性胃空肠吻合组略高,但无统计学差异。单纯黄疸内引流组术后存活3个月以上者有20例(48%)出现上消化道梗阻。作者提出对胰头癌、壶腹周围癌梗阻性黄疸患者只要腹腔内无广泛转移,在黄疸内引流的同时应行预防性胃空肠吻合术。
This article reports 87 cases of obstructive jaundice in pancreatic head and periampullary cancer. They were randomly divided into two groups. One group underwent internal drainage with simple jaundice; the other group underwent prophylactic gastrojejunostomy with internal drainage in the jaundice. Postoperative observation found that the operative mortality and hospital stay were basically the same in the two groups; postoperative complications of intra-abdominal drainage in the prophylactic gastrojejunostomy group were slightly higher, but there was no statistical difference. The upper digestive tract obstruction occurred in 20 patients (48%) who survived more than 3 months after surgery in the jaundice drainage group. The authors proposed that patients with pancreatic cancer and periampullary cancer with obstructive jaundice should be treated with prophylactic gastrojejunostomy as long as there is no extensive metastasis in the abdominal cavity.