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目的探讨保留十二指肠的胰头近全切除术治疗胰头部良性肿瘤的价值。方法回顾性分析2004年1月—2009年12月4例施行保留十二指肠的胰头近全切除术患者的临床资料,均保留了胃肠道的完整性、肝外胆道、胆囊和Oddi括约肌的功能,仅在壶腹周围和胆管后方保留有少量胰腺组织。结果病理证实1例为导管内乳头状黏液瘤,1例为内分泌肿瘤,2例为实性假乳头状瘤。术后2例发生胰瘘,经过非手术治疗治愈。围手术期无死亡。随访8～20个月,均未发现复发征象。结论对于胰头部良性肿瘤,特别是摘除困难的,保留十二指肠的胰头近全切除术是合理的选择。
Objective To investigate the value of subtotal pancreatection of the duodenum in the treatment of benign tumors of the head of pancreas. Methods The clinical data of 4 patients undergoing total pancreatectomy with duodenum retained from January 2004 to December 2009 were retrospectively analyzed. The gastrointestinal integrity, extrahepatic biliary tract, gallbladder and Oddi Sphincter function, only in the ampulla around the bile duct and retain a small amount of pancreatic tissue. Results Pathology confirmed one case of intraductal papillary myxoma, one case of endocrine tumors, and two cases of solid pseudopapillary tumors. 2 cases of pancreatic fistula occurred, after non-surgical treatment. Perioperative no death. Follow-up 8 to 20 months, no signs of recurrence were found. Conclusion For the benign tumors of the head of the pancreas, especially for the difficult removal of the duodenum, the resection of the pancreas near the whole head is a reasonable choice.