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雑誌文献

臨床外科76巻1号

2021年01月発行

文献概要

特集 徹底解説 術後後遺症をいかに防ぐか—コツとポイント 膵臓癌

膵切除後の消化吸収障害・脂肪肝—膵外分泌機能温存のポイント

著者: 北畑裕司1 廣野誠子1 山上裕機1

所属機関: 1和歌山県立医科大学外科学第2講座

ページ範囲:P.72 - P.78

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【ポイント】
◆再建において,安全確実な膵消化管吻合を施行する.
◆膵酵素剤を中心とした栄養補充療法を積極的に行う.
◆縮小手術も考慮した適切な術式選択をし,膵切除量を必要最小限に抑える.

参考文献

1)Hirono S, Kawai M, Okada K, et al:Mesenteric approach during pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. Ann Gastroenterol Surg 1:208-218, 2017
2)村上義昭,上村健一郎,近藤 成,他:膵切除術における機能温存の考え方.膵臓32:706-213,2017
3)岸和田昌之,加藤宏之,伊佐地秀司:膵頭十二指腸切 除術における周術期・術後管理の薬物治療.胆と膵30:591-595,2009
4)Nagai M, Sho M, Satoi S, et al:Effects of pancrelipase on nonalcoholic fatty liver disease after pancreaticoduodenectomy. J Hepatobiliary Pancreat Sci 21:186-192, 2014
5)DiMagno EP, Go VL, Summerskill WH:Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl J Med 288:813-815, 1973
6)中村光男,松本敦史,丹藤雄介,他:膵外分泌機能不全の診断法の進歩と膵酵素補充療法の問題点.胆と膵37:123-128,2016
7)Okano K, Murakami Y, Nakagawa N, et al:Remnant pancreatic parenchymal volume predicts postoperative pancreatic exocrine insufficiency after pancreatectomy. Surgery 159:885-892, 2016
C-labeled mixed triglyceride breath test. World J Surg 39:516-525, 2015
9)Hirono S, Kawai M, Okada K, et al:Modified Blumgart mattress suture versus conventional interrupted suture in pancreaticojejunostomy during pancreaticoduodenectomy randomized controlled trial. Ann Surg 269:243-251, 2019
10)Tani M, Kawai M, Hirono S, et al:Randomized clinical trial of isolated Roux-en-Y versus conventional reconstruction after pancreaticoduodenectomy. Br J Surg 101:1084-1091, 2014
11)Tani M, Kawai M, Hirono S, et al:A prospective randomized controlled trial of internal versus external drainage with pancreaticojejunostomy for pancreaticoduodenectomy. Am J Surg 199:759-764, 2010
12)Kawai M, Tani M, Hirono S, et al:Pylorus ring resection reduces delayed gastric emptying in patients undergoing pancreatoduodenectomy. A prospective, randomized, controlled trial of pylorus-resecting versus pylorus-preserving pancreatoduodenectomy. Ann Surg 253:495-501, 2011
13)Tani M, Terasawa H, Kawai M, et al:Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy. Results of a prospective, randomized, controlled trial. Ann Surg 243:316-320, 2006
14)Tani M, Onishi H, Kinoshita H, et al:The evaluation of duct-to-mucosal pancreaticojejunostomy in pancreaticoduodenectomy. World J Surg 29:76-79, 2005
15)Tani M, Kawai M, Hirono S, et al:A prospective randomized controlled trial of internal versus external drainage with pancreaticojejunostomy for pancreaticoduodenectomy. Am J Surg 199:759-764, 2010
16)Hirono S, Tani M, Kawai M, et al:A central pancreatectomy for benign or low-grade malignant neoplasms. J Gastrointest Surg 13:1659-1665, 2009

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1278

印刷版ISSN:0386-9857

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