目的 探讨十二指肠良性肿瘤的诊断与治疗。方法 对1992~1998年间收治的10例患者的临床资料行回顾性总结分析。 结果术前经纤维十二指肠镜确诊7例 ，上消化道X线钡餐确诊3例。肿瘤位于十二指肠降部7例，球部3例。其中6例行手术治疗，4例因心肺脑等严重合并症行保守治疗。手术为十二指肠肿瘤局部切除连同周围肠壁组织部分切除。术后病理报告2例为平滑肌瘤，2例为布鲁氏纳氏腺瘤，2例为间质瘤。结论 十二指肠良性肿瘤可引发严重并发症，如出血、腹痛、肠梗阻、穿孔等，并约有15%的病例可发生恶变。一经诊断，应及早手术治疗，手术一般宜行局部切除。
Objective To explore the key technique of allogeneic whole pancreaticoduodenal transplantation (WPDT) in rats. MethodsWPDT model was established between Lewis rats as donors and Wistar rats (with type 1 diabetes mellitus) as recipients. End to side anastomosis was performed in abdominal aorta of donors and recipients. The portal vein of the graft was anastomosed with the recipients left renal vein by cuff technique. And side to side anastomosis was made between the graft duodenum and the host jejunum. ResultsForty-four of 50 rats were successfully performed WPDT. Amongthem, 8 rats died in postoperative 3 days, the survival time of residual 36 rats was 6-16 days, with an average of (10.45±3.30) days. The peak of death appeared on day 7-10 after operation. The typical acute rejection in pathological changes were observed on day 7. ConclusionSkilled microsurgical techniques and emphasis on details are important to establish WPDT model.
目的 探讨胰十二指肠切除术后严重并发症的防治方法。方法 分析2002～2005年7例胰十二指肠切除术后严重并发症的资料。结果 手术严重并发症发生率为25.9%（7/27），经积极治疗后无一例死亡。结论 术中仔细操作和操作技术改进是降低胰十二指肠切除术并发症发生率的关键，并发症经积极治疗后有望痊愈。
目的探讨保留幽门的胰十二指肠切除术(PPPD)的手术适应证、捆绑式胰肠吻合术的特点及胃排空障碍的治疗。方法12例均行PPPD，消化道重建按Child法，胰肠吻合均采用捆绑式胰肠吻合。结果除1例术后第21天并发切口裂开、肺栓塞死亡外，其余11例均顺利出院，平均住院时间24 d，随访1年，1例术后8个月死亡，余均健在。结论PPPD是治疗胰头癌及壶腹周围癌的一种具有广阔应用前景的术式，捆绑式胰肠吻合有望作为胰肠吻合的标准术式。
ObjectiveTo investigate the effect of drained versus nondrained pancreaticojejunostomy on prevention of the pancreatic leakage after pancreaticoduodenectomy. MethodsSeventysix patients underwent the standard pancreaticoduodenectomy including resection of the distal stomach,common bile duct, the head of pancreas and the duodenum.Pancreaticenteric reconstruction was accomplished via either pancreaticojejunostomy by endtoside anastomsis or pancreaticojejunostomy by ducttomucosa anastomsis.The stented external drainage of pancreatic duct was used in 45 of 76 patients. ResultsPancreatic leakage was identified in 1 patient in the drained group consisting of 45 patients,in 7 patients in the nondrained group consisting of 31 patients, the incidence of pancreatic leakage in the drained group (2.2%) was significantly less than in the nondrained group (22.6%,P＜0.05).ConclusionComparing the incidences of pancreatic leakage from both groups,the authors believe that the stented external drainage of pancreatic duct can significantly reduce the incidence of pancreatic leakage after pancreaticoduodenectomy.
目的 探讨小儿十二指肠不同程度外伤性破裂的临床表现及治疗方法。方法 对我院1994~1998年收治的8例十二指肠损伤患儿的临床资料进行回顾性分析。结果 ①全部患儿均有上腹部外伤史； ②大多数破裂处位于十二指肠第三段； ③单纯缝合修补加近端十二指肠隧道式造瘘术是有效的治疗方法。结论 小儿十二指肠外伤性破裂以十二指肠第三段为主，单纯缝合修补加近端十二指肠隧道式造瘘术是简单易行的手术方法。