ObjectiveTo summarize of clinical application and progress of duodenum-preserving pancreatic head resection (DPPHR).MethodThe relevant literatures published recently at domestic and abroad about the clinical application and progress of DPPHR were collected and reviewed.ResultsFor the benign lesions, low-grade malignancies and borderline tumors of the head of pancreas, the DPPHR could achieve the same expected therapeutic effect as the classical pancreatoduodenectomy. The DPPHR could reserve the continuity of stomach and duodenum while resecting lesions and improve the symptoms of patients, reduce the reconstruction of digestive tract and the resection of pancreas and surrounding tissues as much as possible, and retain the pancreas-intestinal axis, which was more in line with the physiology of human beings.ConclusionsAt present, DPPHR is worthy of further development and promotion in department of pancreas surgery, but current studies only focus on occurrence of short-term complications after operation. Because patients with benign diseases of pancreatic head have better prognosis and longer survival time after operation, we should pay attention to the long-term complications such as diarrhea, anemia and reflux cholangitis. More clinical studies need in future to be demonstrated superiority of DPPHR in clinical efficacy and to evaluate occurrence of long-term complications and their impact on quality of life of patients with DPPHR by comprehensive analysis of multiple evaluation indicators.
ObjectiveTo summarize and analyze the long-term clinical effect of duodenum-preserving pancreatic head resection (DPPHR) versus pancreaticoduodenectomy.MethodsThe clinical data of 102 patients who underwent DPPHR (n=35) or pancreaticoduodenectomy (n=67) from January 2014 to December 2019 in The First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively.ResultsThe operations of patients in the DPPHR group and the PD group were successfully complete, no one died during operation or perioperative period. The weight gain in one year after operation and incidences of exocrine dysfunction in the DPPHR group were all better than those of the PD group (P<0.05), but there was no significant difference on the other complications between the two groups (P>0.05). The pain score, diarrhea score, and the overall health status score in one year after operation significantly improved in the DPPHR group than those in the PD group (P<0.05).ConclusionDPPHR is more beneficial to improve the quality of life after operation, and is a better surgical procedure for benign and low-grade malignant diseases of pancreatic head.
ObjectiveTo investigate the role of local pancreatectomy for benign and low-grade malignant pancreatic tumors.MethodThe clinical data of 45 patients with benign and low-grade malignant pancreatic tumors who underwent local pancreatectomy from January 2014 to June 2019 in Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology were analyzed.ResultsForty-five patients underwent the local enucleation or resection with negative margin. The pathological results showed that there were 17 cases of solid pseudopapilloma, 5 cases of mucinous cystadenoma, 4 cases of serous cystadenoma, 10 cases of islet cell tumor, 5 cases of nonfunctional neuroendocrine tumor, 4 cases of congenital cyst. There were 6 cases of head of pancreas, 26 cases of body of pancreas, 8 cases of tail of pancreas, 5 cases of uncinate process. The tumor was 1.2 to 9.0 cm in diameter with an average of 3.2 cm. Among them, the diameter was more than 5.0 cm in 9 cases. The incidence of pancreatic fistula after operation was 57.8%, 65.4% was grade A fistula, 34.6% was grade B fistula, and no grade C fistula occurred. The incidence of abdominal infection was 13.3%, incidence of abdominal hemorrhage was 6.7%. There was no secondary diabetes mellitus and pancreatic endo- and exocrine dysfunction, and no death case.ConclusionsPancreatic enucleation for benign and low-grade malignant pancreatic tumors after strict preoperative evaluation can effectively preserve the pancreatic endocrine function of patients. Although the incidence of pancreatic fistula is high, it is mostly biochemical fistula, and the incidence of serious complications is low.
ObjectiveTo summarize the related researches of pancreatic portal hypertension (PPH) in recent years in order to diagnose and treat the disease more timely and effectively. MethodThe literatures relevant to etiology, mechanism, clinical features, diagnostic criteria, and treatment of PPH were searched and reviewed. ResultsThe occurrence of PPH was related to its anatomical structure. Its clinical manifestations were not characteristic, but it was not difficult to diagnose by the assistance of auxiliary examinations. The treatment of PPH was mainly targeted at pancreatic diseases and portal hypertension, and the treatment targeted at portal hypertension was performed according to the situation with or without gastrointestinal bleeding. So, in clinical practice, different treatment measures should be taken according to different situations. ConclusionAt present, the clinical diagnosis and treatment of PPH is relatively mature, but its preventive treatment is still controversial, which will be the focus of future research.