胰十二指肠的

objective:to investigate the therapeutic action of somatostatin in pancreatic leakage after pancreaticoduodenectomy.methods: to collect 100 patients with pancreaticoduodenectomy during 2003～2006,contrast 44 patients use somatostatin after pancreaticoduodenectomy as experimental group,and 56 patients with conventional therapy as control group.results:there were no pancreatic leakage case in the modified group of 44 cases.3 cases complicating pancreatic leakage occurd in control group,and the proportion of pancreatic leakage are different examined by statistic mathord.conclusions:use somatostatin after pd can restrain organism excrete diastase vera,and help anastomotic stoma to concrescent and decrease pancreatic leakage;pancreatic leakage should be treated by different grades,grade 1 can be cured by persistent drainage with somatostatin and nutritional support;grade 2 should be pay more energetic intervention.

作者单位：潍坊医学院，潍坊 261042；潍坊市人民医院肝胆外科，潍坊 261042 目的：探讨生长抑素在胰十二指肠切除术后减少胰漏的作用。方法：收集2003年1月～2006年12月施行pd患者100例，术后应用生长抑素持续泵入病人44例，并与同期施行的pd术后常规应用全肠外营养及抗生素治疗病人56例，结果进行了对比观察。结果：实验组病人44例无1例发生胰漏，对照组56例病人，3例发生不同程度的胰漏，发生率5.3%，统计学比较有显著差异（p＜0.05）。结论： pd后应用生长抑素持续泵入可以抑制胰酶的作用，使胰肠吻合口较好地愈合，从而有效地减少胰漏的发生；胰漏可进行分级治疗，ⅰ级胰漏采用通畅引流为主，同时使用生长抑素和营养支持等治疗多可治愈，ⅱ级胰漏需要积极治疗。

objectiveto investigate the diagnosis and treatment of traumatic duodenal rupture.methodthe clinical data of 13 patients with traumatic duodenal rupture hospitalized from may 1991 to december 2008 were retrospectively analyzed,and the material cause was automobile accident mainly.resultsin these 13 patients,after hospitalization,6 cases were diagnosed in 3 hours,4 cases were diagnosed in 24～72 hours,and 3 cases were diagnosed after 72 hours.three cases with duodenal cleft repair,2 cases with duodenal ostomy,2 cases with duodenum and jejunum roux-en-y anastomosis,1 case with duodenal diverticular surgery,1 case with meliorative duodenal diverticular surgery,1 case with duodenal broken ends closure and anastomosis of stomach with jejunum,1 case with duodenal distal closure and anastomosis of duodenal local with jejunum,and 2 cases with resections of pancreas duodenum.after the operation,6 cases (46.2%) appeared some complications of wound infection,duodenal fistula,digestive tract hemorrhage,pancreatic fistula,abdomen infection and so on.two cases (15.4%) died from multiple system organ failure and septic shock.conclusionthe early diagnosis and correct operation style selection are the keys for duodenal rupture.

目的：探讨外伤性十二指肠破裂的诊断和治疗方法。方法：回顾分析外伤性十二指肠破裂患者13例临床资料。结果：入院后3 h内确诊6例，24～72 h内确诊4例，72 h后确诊3例。3例行十二指肠裂口修补，2例行十二指肠造瘘，2例行十二指肠空肠roux-en-y吻合，1例行十二指肠憩室化手术，1例行改良十二指肠憩室化手术，1例行十二指肠两断端关闭、胃空肠吻合，1例行十二指肠远端关闭、近端与空肠端侧吻合，2例行胰十二指肠切除术。术后6例(46.2%)出现切口感染、十二指肠瘘、消化道出血、胰瘘或腹腔感染等并发症，2例(15.4%)患者死亡，分别死于多器官系统衰竭和感染中毒性休克。结论：早期诊断与正确的术式选择是成功救治外伤性十二指肠破裂的关键。

The anatomical detect skill and mosquito clamp cross technique to peel off invasived vascular were adopted.58patients were undergone pancreatico duodenectomy,and the rate of resects was95%.The cases of near to the invasived vascular malignant tissue was41,and the cases of the lymph node metastasis was27,and the cases of around pancreatic nerve was30.1case died of bleeding,and the morbidity of complication was found in14cases,and no patients occurred fistula.

病例报告］回顾性分析 2003年9月―2006年6月间收治的61例壶腹部周围癌病人临床资料，采用解剖性探查及纹式钳勾划技术，给58例病人施行了一次性胰十二指肠切除术，手术切除率为95%，其中41例癌细胞侵入周边大血管，27例发生淋巴结转移，30例癌细胞侵入胰周神经丛。58例手术患者中围手术期死亡1例，出现并发症者为14例，未见并发胰漏及胆漏病例。

The duodenoscopy and the biopsy are the principle methods for the diagnosis of the duodenal tumor; the therapy varies as the location of the tumor differs in such a way that the gastroduodenotectomy is advisable mainly for the tumor above the papilla, the duodenal segmental excision is for the tumor below the papilla, and either the pancreatoduodenectomy or the local excision of the duodenal tumor is to be the choice for the papilla periphery tumor according to the biological property of the tumor itself.

纤维十二指肠镜检查和活检是诊断十二指肠肿瘤的主要方法；肿瘤部位不同，治疗方法亦异，乳头上方肿瘤以胃十二指肠切除为主，乳头下方肿瘤以十二指肠节段性切除为主，乳头周围肿瘤根据肿瘤生物学特性选择胰十二指肠切除或经十二指肠肿瘤局部切除或ESE。

The duodenoscopy and the biopsy are the principle methods for the diagnosis of the duodenal tumor; the therapy varies as the location of the tumor differs in such a way that the gastroduodenotectomy is advisable mainly for the tumor above the papilla, the duodenal segmental excision is for the tumor below the papilla, and either the pancreatoduodenectomy or the local excision of the duodenal tumor is to be the choice for the papilla periphery tumor according to the biological property of the tumor itself.

纤维十二指肠镜检查和活检是诊断十二指肠肿瘤的主要方法；肿瘤部位不同，治疗方法亦异，乳头上方肿瘤以胃十二指肠切除为主，乳头下方肿瘤以十二指肠节段性切除为主，乳头四周肿瘤根据肿瘤生物学特性选择胰十二指肠切除或经十二指肠肿瘤局部切除或ESE。

AIM: To prevent postoperative pancreatic leakage by applying modified Child pancreaticojejunostomy in pancraticoduodenectomy patients due to severe pancreaticoduodenal injury.

目的：采用改良Child胰肠吻合对胰肠吻合缝合技术进行改进，对严重的胰头、十二指肠损伤患者急诊行胰十二指肠切除术，预防胰漏发生。

Methods: After the model of transplanted pancreatic cancer was established in nude mice with orthotransplantation of human pancreatic cancer cell line into the pancreas, the ischemia of the right lobe of the pancreas was induced with ligation of the gastroduodenal, inferior pancreaticoduodenal and dorsal pancreatic arteries.

在建立人胰腺癌细胞株裸小鼠胰腺原位移植瘤模型的基础上，结扎荷瘤裸鼠胃十二指肠动脉、胰十二指肠下动脉及背胰动脉诱导胰腺右叶区域性缺血，观察缺血对裸小鼠胰腺移植癌群体增殖动力学及细胞周期动力学的影响。

Results The frequency of multislice CT to display peri-pancreatic big arteries including celiac trunk, common hepatic artery splenic artery, gastroduodenal artery and superior mesenteric artery was 100% while that of small arteries including dorsal pancreatic artery, transverse pancreatic artery, pancreaticomegana artery, caudal pancreatic artery, superior pancreaticoduodenal artery and inferior pancreaticoduodenal artery was

结果 多层螺旋CT对正常胰腺周围大动脉（腹腔干，肝总动脉，脾动脉，胃十二指肠动脉，肠系膜上动脉）的显示率为100%，对小动脉（胰背动脉，胰横动脉，胰大动脉，胰尾动脉，胰十二指肠上动脉，胰十二指肠下动脉）的显示率为

Complete resection was achieved in all cases, including pancreatoduodenectomy in 13 cases, by pylorus-preserving pancreatoduodenectomy in 3 cases, and tumor enucleation in 7 cases.

行胰十二指肠切除术13例，其中4例合并右半结肠切除术，1例合并右肝转移灶切除，2例合并右肝脓肿引流术；行保留幽门的胰十二指肠切除术3例；行肿瘤局部切除术7例。

Methods A patient of the gallbladder cancer with invasion of liver, gastric antrum, duodenum, caput pancreatis and colon transversum, was received radical resection (including pancreatoduodenectomy, hepatectomy and colectomy).

胆囊癌患者1例合并有中肝叶、胃窦、十二指肠、胰头及横结肠的广泛侵犯。经充分的术前准备，我们为其施行了根治性切除术，即胰十二指肠切除术+中肝叶切除术+横结肠切除术。

But we don't care about Battlegrounds.

但我们并不在乎沙场中的显露。

Ah! don't mention it, the butcher's shop is a horror.

啊！不用提了。提到肉，真是糟透了。