呼声程序:一个单一机构的案例系列和文献审查
Sibi Krishna Thiyagarajan1, Shalyn Fullerton1, Alfredo Verastegui1
1Department of Surgery, Mayo Clinic, Jacksonville, FL, USA.
The American surgeon
|October 8, 2025
概括
惠普尔 (Whipple + Distal) 是对精选患者的一种安全的胰腺手术,平衡癌症控制与功能维护. 需要更多的数据来确认其长期疗效,并鼓励更广泛的使用.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 胰腺手术 胰腺手术
背景情况:
- 惠普尔 (Whipple + Distal) 是一种罕见的护囊细胞保护胰腺切除技术.
- 它适用于某些患有胰腺头部和尾部疾病的患者,可能是在之前的胰腺切除术后.
- 手术切除是胰腺管道腺癌 (PDAC),细胞癌 (RCC) 转移和多焦点内导管膜性瘤 (IPMN) 的标准.
研究的目的:
- 评估威斯塔尔技术的安全性和结果.
- 为了比较同时使用的Whistal (CW) 和分阶段的Whistal (SW) 方法.
- 评估Whistal在治疗复杂的胰腺病理方面的可行性.
主要方法:
- 一个前性数据库 (1999年8月至2024年3月) 的回顾性审查.
- 分类为分阶段哨声 (SW) 和并发哨声 (CW).
- 使用Clavien-Dindo和ISGPS分级评估术后结果;报告的Whistal病例的文献综述.
主要成果:
- 对PDAC,RCC转移,IPMN和胆道狭窄进行了五次口哨切除 (3CW,2SW).
- 主要发病率,手术后胰腺 (POPF) 和延迟胃排空 (DGE) 均为40%.
- 在文献搜索中,在26个出版物中发现了52个额外的Whistal案例.
结论:
- 对于需要胰腺切除的经过精心挑选的患者来说,Whistal是一种安全的外科选择.
- 需要进一步的研究和长期数据来验证其有效性并促进更广泛的临床采用.
- 该技术在瘤控制和胰腺功能保护之间提供了潜在的平衡.
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