胰头占位伴致密钙化手术切除.PDFVIP

中国普外基础与临床杂志 2018 年8 月第25 卷第x 期 • 1 •   ·创新复杂手术荟萃 · 胰头占位伴致密钙化的手术切除 朱芸杰，王力，陈阳，田伯乐 四川大学华西医院胰腺外科（成都  610041 ） 【摘要】   目的    评估保留十二指肠的胰头切除治疗胰头致密钙化占位的预后，总结手术要点。方法     回顾 性分析入四川大学华西医院胰腺外科于 2016 年 5 月收治的 1 例罕见的胰头占位伴致密钙化的中年女性患者的临 床资料。结果    患者切除手术顺利完成，手术时间 207 min ，术中出血量约为 130 mL ，术后住院时间为 12 d 。患 者于术后 3 d 拔除胃管并下床活动，每日腹腔引流量约为 30 mL ，至术后 7 d 引流量减至 10 mL ，拔除腹腔引流 管。术后每 2 天复查血清学淀粉酶及体液淀粉酶浓度，指标均正常。患者术后未诉特殊不适，术后无明显胰瘘、 十二指肠瘘、胆汁漏、胃排空延迟、腹腔积液、胸腔积液、腹腔感染及腹腔出血发生。术后随访 18 个月，预后良 好，无复发征象，无特殊不适。结论    针对罕见的胰头占位伴致密钙化，行保留十二指肠的胰头切除可取得较好 的预后。 【关键词】  胰头占位；胰头致密钙化；保留十二指肠胰头切除；预后 Surgical resection of extensive calcification of pancreatic head ZHU Yunjie, WANG Li, CHEN Yang, TIAN Bole Department of Pancreatic Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China Corresponding author: TIAN Bole, Email: hxtbl0338@126.com 【Abstract 】 Objective    To estimate the prognosis of duodenum-preserving resection of pancreatic head (DPRPH) in the treatment of extensive calcification of pancreatic head, and to summarize the key points of surgery. Methods    The clinical data of a middle-aged woman with rare extensive calcification of pancreatic head who underwent surgery in Department of Pancreatic Surgery of West China Hospital in May. 2016 was collected and analyzed. Results    The operation was successfully completed, with the operative time was 207 min, the intraoperative blood loss was 130 mL, and the hospital stay was 12 d. Removing the gastric tube and off-bed activity were on the 3rd day after operation, and the volume of peritoneal drainage per day was decreasing from 30 mL to 10 mL until 7th day after operation. We made examination of serum amylase and fluid amylase for the patient every 2 days, and the examination indexes were withi