慢性胰腺炎的切除引流术的临床进展：从Beger手术到Berne手术

Clinical Progression of Resection and Drainage Surgery for Chronic Pancreatitis: From Beger Surgery to Berne Surgery

摘要: 胰头切除术(Pancreatic Head Resection, PHR)是一种以保留功能器官为特点的胰腺外科技术，尤其适用于慢性胰腺炎、胰腺良性肿瘤的外科干预。具有组织创伤小、出血少、住院时间短、保留更多胰腺组织等明显优势。DPPHR现已成为治疗胰头良性病变的重要方式，其中主要包括三种代表性术式：保留十二指肠的胰头切除术(Duodenum-Preserving Pancreatic Head Resection, Beger Procedure)、局限性胰头切除加胰管纵切空肠吻合术(Partial Pancreatic Head and Side-to-Side Pancreaticoduct-Jejunal Anastomosis, Frey Procedure)以及保留十二指肠次全胰头切除术(Pylorus-Preserving Subtotal Pancreatic Head Resection, Berne Procedure)。对于胰腺良性病变，传统胰十二指肠切除术需要整体切除胰头部(包括胰头和钩突)、全部十二指肠、胆囊、胆总管下端、远端胃、近端空肠(约15~20 cm)，该术式因切除范围广泛，严重破坏了消化系统的完整性和功能性，影响了患者术后的生活质量。

Abstract: Pancreatic head resection (PHR) is a pancreatic surgical technique characterized by the preservation of functional organs. It is particularly indicated for chronic pancreatitis and benign pancreatic tumors, offering notable advantages such as reduced tissue trauma, minimal blood loss, shorter hospital stay, and greater preservation of pancreatic parenchyma. DPPHR has now become an important surgical approach for benign lesions of the pancreatic head, with three representative procedures being predominantly utilized: the duodenum-preserving pancreatic head resection (Beger procedure), partial pancreatic head resection with longitudinal pancreatic duct-jejunal anastomosis (Frey procedure), and the pylorus-preserving subtotal pancreatic head resection (Berne procedure). For benign pancreatic lesions, the conventional pancreaticoduodenectomy involves en bloc resection of the pancreatic head (including the head and uncinate process), the entire duodenum, the gallbladder, the distal common bile duct, the distal stomach, and a proximal segment of the jejunum (approximately 15~20 cm). This procedure, characterized by its extensive resection, substantially disrupts the integrity and function of the digestive system, thereby impairing the patient’s postoperative quality of life.