保留幽门的胰十二指肠切除与标准胰十二指肠切除术后胃排空延迟的对比研究

摘要

目的：探讨保留幽门的胰十二指肠切除术（PPPD）与标准胰十二指肠切除术（SWPD）后胃排空延迟（DGE）的临床特点。方法回顾性分析近三年内连续收治的105例壶腹周围占位手术病例，均由同一手术治疗组完成，其中53例行PPPD，52例行SWPD。比较两种手术方式的术后DGE发病率和临床转归特点。结果与SWPD组相比，PPPD组术后DGE发生率为32.1%，显著高于SWPD组的13.5%，有统计学差异（P＝0.023），但PPPD组术后DGE症状相对较轻，术后DGE持续时间短于SWPD组。结论 PPPD术后DGE发生率较SWPD高，但症状相对较轻，恢复较快，提示两者发生机制可能有所不同，需针对性地采取不同的应对措施防治术后DGE。%Objective To study the clinical characteristics of delayed gastric emptying undergoing pylorus-preserving pancreaticoduodenectomy (PPPD) and standard whipple procedure (SWPD). Methods 53 patients who underwent PPPD and 52 patients who underwent SWPD between January 2010 and July 2013 were investigated retrospectively. To analysis the incidence and clinical characteristics of DGE between PPPD and SWPD. Results The occurrence rate of DGE after PPPD was higher significantly than that atter SWPD(32.1%vs. 13.5%, P=0.023). but in PPPD group, the clinical symptoms was lighter and recovery faster. Conclusions The occurrence rate of DGE after PPPD was higher significantly than that atter SWPD, but in PPPD group, the clinical symptoms was lighter and recovery faster.so the mechanism of PPPD and SWPD might be different, we need to take different measures to prevention and treatment of postoperative DGE.