A Modern Review of the Operative Management of Chronic Pancreatitis
A Modern Review of the Operative Management of Chronic Pancreatitis
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慢性胰腺炎手术治疗的现代回顾
DOI：
10.1177/000313481007601010
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
O. Hines
中科院分区：
文献类型：
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作者：
Jonathan C. King;Shannon Abeywardina;J. Farrell;H. Reber;O. Hines
慢性胰腺炎是一种衰弱的疾病，导致疼痛、肠道吸收不良、内分泌功能障碍和生活质量(QOL)下降。我们的目的是分析慢性胰腺炎患者的手术结果。回顾了1990至2009年间接受慢性胰腺炎手术的患者的数据。对人口统计学、手术和围手术期数据以及存活率进行分类。测定生活质量(简表36和欧洲癌症研究与治疗组织生活质量问卷+PAN-26)，并与历史对照进行比较。平均年龄51±2岁，男性38例(53%)，最常见的指征是疼痛(71%)，病因多为酒精，多数患者行惠氏手术(56%)。手术时间316±17分钟，出血量363±75毫升。30例(42%)发生并发症34例，死亡1例。对55例存活患者中的25例(45%)进行了生活质量调查，平均随访72±16个月。平均生存期为99±9个月，5年和10年生存率分别为86%和75%。生活质量得分一致好于历史对照组。我们的数据表明，慢性胰腺炎的手术可以在可接受的发病率和死亡率下进行。与历史对照组相比，患者的存活率和生活质量都有很好的改善。对于慢性胰腺炎患者来说，手术是一种有效而持久的治疗选择。
Chronic pancreatitis is a debilitating disease resulting in pain, intestinal malabsorption, endocrine dysfunction, and poor quality of life (QoL). Our aim was to analyze surgical outcomes for patients with chronic pancreatitis. Data for patients undergoing operations for chronic pancreatitis between 1990 and 2009 were reviewed. Demographics, operative and perioperative data, and survival were catalogued. QoL was determined (Short Form 36 and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire + PAN-26) and compared with historical controls. The mean age was 51 ± 2 years, 38 patients were male (53%), the most common indication was pain (71%), the etiology of pancreatitis often was alcohol, and most patients underwent a Whipple procedure (56%). Operative time was 316 ± 17 minutes and blood loss was 363 ± 75 mL. There were 34 complications in 30 patients (42%) and one death. QoL surveys were administered for 25 of 55 (45%) surviving patients at a mean follow-up of 72 ± 16 months. Mean survival was 99 ± 9 months, whereas 5- and 10-year survival were 86 and 75 per cent. QoL scores were uniformly better than historical controls. Our data demonstrate that operations for chronic pancreatitis can be performed with acceptable morbidity and mortality. Patients have excellent survival and improved QoL compared with historical controls. Surgery is an effective and durable treatment option for patients with chronic pancreatitis.