Kết quả của phẫu thuật cắt đầu tụy tá tràng tại khoa ngoại Bệnh viện Bạch Mai

- DSKC la phUdng phap tap an toan cho benh

nhan Silicosis.

TAI LIEU THAM KHAO

1. Hoang Bao Chau - Phuang phap xoa bop y hoc

dan tgc. NXBYH 1988.

2. Nguyin Thj Chinh, Trjnh Binh Dy: ThSm do chUc

nSng thong khi. Benh hoc lao va benh phoi. NXB Y hoc

1996, tap 2 44-58.

S.Tran Oang Dong - Nghien cUu bien doi hinh thai va

chUc nang phoi do tiep xuc vdi bui silic. Luan an pho tien

sy khoa hoc y duac 1988.

4. Trinh Binh Dy, Nguyin VSn Tudng: ThSm do chUc

nSng ho hap. Mot so tham do chUc nSng sinh ly. NXB Y

hoc 1993, 14-54.

5. DUdng Xuan Dam - Nghien cUu mgt phuang phap

dudng sinh doi vdi ngudi cao tuoi. Luan an pho tie'n sy

khoa hgc y duac 1996.

6. Nguyin Dinh Hudng, Trinh Binh Dy, Nguyin Van

Tudng, Tran Thj Dung: Tong ket 25 ndm nghien cUu

thong khi phoi. Bao cao hdi nghi chUc nSng hd hSp tai

vien lao va b§nh phSi 10/6/1996.

' 7. Nguyin Van Hudng - Phuang phap dudng sinh,

Trung Udng hoi y hgc co truyen Viet Nam nSm 1996.

8. Bui Xu§n Tam: Cac hdi chdng rdi loan thdng khi

phoi. Bai giang bdnh hoc ngi khoa sau dai hgc. Hgc vien

quan y 1991, tapl, 200-206.

9. Le Ba Thuc: Nghien cdu thdng khi phoi ngUdi binh

thudng va benh nhan mac mgt sd benh phe quan. Luan

an phd tien sy khoa hgc y dugc 1996.

10. Le Trung: Benh bui phdi silic nghe nghiep. NXB

Yhoc 1990

i l . Vien YHLD & VSMT: Nghien cUu xay dung tieu

chuan ve sinh mdi trudng. de tai cap nha nudc 2000-

2002.

12. Beers M.H., Berkow R : Silicosis in the Merck

manual of diagnosis and therapy, 17^ Ed, Mecrk

research laboratories, USA 1999, 620-622.

KET QUA CUA PHAU THUAT CAT DAU TUY TA TRANG

TAI KHOA NGOAI BENH VIEN BACH MAI

NGUYI N NGQC BfCH vd cpng sir

Khoa Ngoai benh vien Bach Mai

TOMTAT

ChU de: Phau thuat Ccit dau tuy ta trang tai khoa

Ngoai Benh vien Bach Mai

Ddi tuang va phuang phap : Gdm 87 trudng hap

(TH) c^t dau tuy ta trang dugc thuc hien trong 8 nSm

do mgt nhom phiu thuat theo mgt quy trinh ky thuat

thdng nhat, cd cai tien. Cac chi dinh ph§u thuat do

nguyen nhan: ung thu dau tuy (33 TH), ung thu bdng

Vater (29), viem tuy man tlnh va soi (5 TH), u ta trang

(5 TH), chan thuang dau tuy ta trang(3TH) va ung thu

thap dudng mat (2 TH). Nghien cCtu duac thuc hien

btng phuang phap md ta hdi va tien cifu tCf nSm

2002 den 5/2009

Ket qua : Ta't ca cac trudng hgp deu cit dugc

thuang tdn va nao vet hach khi cd chi djnh. Tai bie'n

trong luc md chQ yeu la tdn thuang bd mach mach

treo trang tren 4 TH, xoin mach mac treo 2 TH, vd

lach 2 TH.TCt vong trong thdi gian nim vien 4TH

(4,58%),viem phuc mac sau md 3 TH (3,34%) chay

mau trong d bung 2TH (2,29%) liet rudt sau md keo

dai la dang luu y d 35 TH (40,22%). Thdi gian sdng

them sau md d nhdm ung thu 1 nSm, 3 nSm va 5 nSm

la 56, 25 va 9%.

Ket luan : Phau thuat cit dau tuy ta trang van cdn

la mgt phau thuat Idn va nSng ne cho ngudi benh.

Tuy nhien la sulua chgn can thiet cho cac thuang tdn

quanh vdng Vater, dau tuy khi cd chi dinh. "Dd han

che cac tai bien, bien chLfng sau md ngudi benh phai

dugc chuan bi tdt cung nhu kinh nghiem va ky nSng

cCia phiu thuat vien va gay me hdi sCrc.

TCrkhda: Phiu thuat, cit dau tuy ta trang

SUMMARY

87 cases of duodenopancreatectomy were

performed in BachMai Hospital from 2002 to May

2009 following a modified technic. It consisted 33.

cases of cancer of pancreatic head, 29 cases of'

ampullary adenocarcinoma, 5 cases of chronic

pancreatitis, 5 cases of duodenal tumor, 3 cases of

duodenopancreatic trauma and 2 cases of

cholangioma

The procedures had been done in all the cases

successfully. There were 4 morbidity in the time of

intervention and the mortality was on 4.59%. The

complications post-operative were on 3 cases of

peritonititis (3.34%), 2 cases of intra-abdominal

bleeding (2.29%) especially 35 cases of delayed

gastric emptying (40.22%). The long-term survival on

1, 3 and 5 year were 57.69, 25.92 and 7.69%

respectively.

Keywords: duodenopancreatectomy, BachMai

Hospital

DAT VAN OE:

Phlu thuat cat dau tuy-ta trang dUdc Godivilla (Y)

va Kausch (Dufe) khdi xudng tCr nhOfng nam 1912 sau

nay dUdc Whipple (My) hoan thien va dUdc phd bien

rdng rai sau nam 1935 cho cac benh nhan bj ung thu

bong Vater va ung thu dau tuy(2,3,7). NhiJfng nam 60

cCia the ky trudc den nay phlu thuat cat dau tuy ta

trang thUc sU bijng nd vi sU phat trien cija ky thuat

phlu thuat cung nhU nhOng tie'n bd cua gay me hdi

sufc. Tuy nhien phlu thuat tren vin cdn la mot phlu

thuat nang ne cho ngudi benh vi sU phCfc tap ve tdn

Y HOC THVC HANH (667) - SO 7/2009