A Follow-up Study of Annular Pancreas in Infants and Children

我們分析從1984年至1996年接受環狀胰手術的15個兒科病人，嘔吐是最常見的症狀，其中12個病人有包括旋轉失常（40%），內因性十二指腸狹窄（33%），唐氏症（27%），十二指腸帶（27%）等相關畸形。病人手術時的年齡介於5小時大與8歲半之間，9個人接受十二指腸空腸造口吻合術，5個人接受十二指腸與十二指腸吻合術，1個人接受十二指腸切開術和十二指腸造形術。腸道恢復輸通平均所需時間爲17.9天二指腸空腸造口吻合術平均需22.8天，十二指場與十二指腸吻合術平均需12.3天。所有病人均接受術後追蹤，其中11人長期追蹤至1997年4月，追蹤時間長短從1年2個月至11年不等。術後存活率爲100%，但是其中12人發生包括膽汁鬱滯性黃疸（53%），上消化道蠕動異常（47%），生長遲緩（40%），慢性腹瀉（33%）等併發症。有1病人術後發生慢性復發性胰臓炎，後經證實爲環狀合併分裂胰。至最後一次追蹤時（1997年4月，當時病人年齡爲1歲2個月至18歲9個月不等），仍有1人有脂肪便，3人有吃完油性食物易腹瀉，4人有營養不良，3人有生長遲緩，3人有大做一日和尚撞一天鍾中胰蛋白脢濃度較低的總量。總結來說，密切長期的追蹤對接受過治療的環狀胰病人是必要的，因爲即使術後初期很順利且存活率高，仍有許多在經過一段時間後會産生併發症。

關鍵字

環狀胰；十二指腸空腸造口吻合術；十二指腸與十二指腸吻合術；環狀胰合併分裂胰；胰臓炎

並列摘要

Fifteen pediatric patients undergoing surgery for annular pancreas from 1984 to 1996 were analyzed. Vomiting was the most common presenting symptom. Twelve patients (80%) had associated anomalies including malrotation (40%), intrinsic duodenal obstruction (33%), Down syndrome (27%) and duodenal bands (27%). Their ages at operation were between 5 hours and 8.5 years, with a median of 4 days. Surgical treatment included duodenojejunostomy in nine, duodenoduodenostomy in five and duodenotomy with duodenoplasty in one. The mean druation for reestablishment of bowel transit was 17.9 days, with 22.8 days for duodenojejunostomy and 12.3 days for duodenoduodenostomy. All cases received postoperative follow-up, but only 11 of them were long-term followed until April 1997, with a duration ranging from 1 year and 2 months to 11 years, with a median of 7 years and 5 months. The survival was 100%, but 12 cases (80%)developed postoperative complications including cholestatic jaundice (53%), upper gastrointestinal motility disorder(47%), failure to thrive (40%)and chronic diarrhea (33%). Annular pancreas divisum was noted in one case with chronic relapsing pancreatitis.At the end of follow-up (April 1997), when final ages ranged from 1 year and 2 months to 18 years and 9 months with a median of 7 years and 5 months, there were still problems: steatorrhea in 1, diarrhea after fatty diet in 3, malnutrition in 4, failure to thrive in 3 and lower concentration of stool trypsin in 3 cases. In conclusion, close long-term follow-up is essential for infants treated for annular pancreas because many of them can be expected to develop complications, even if the initial postoperative period is uncoplicated and survival is excellent.

並列關鍵字

annular pancreas ； duodeojejunostomy ； duodenoduodenostomy ； annular pancreas divisum ； pancreatitis

國際替代計量

A Follow-up Study of Annular Pancreas in Infants and Children

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