摘要
目的探讨胰头癌手术中,与传统手术方法比较,切断胰腺显露受累门静脉法对提高切除率的作用。以及胰头癌姑息性切除的临床意义。方法回顾10年间手术治疗的94例累及门静脉的胰头癌。1997年1月～2002年3月45例为传统手术方法组;2002年3月～2007年5月49例为手术改进组,对有血管浸润者,采取切断胰腺显露受累门静脉的方法切除肿瘤,配合局部放疗、化疗。并进行随访。结果传统手术方法组总的切除率35.56%;直接切断胰腺法组65.31%,P=0.0075。两组围手术期并发症及死亡率无显著差别。前者术后6个月生存率97.78%,1年71.11%,3年24.44%;后者分别为97.96%,75.51%,46.94%。术后3年生存率比较,差异有显著性,P=0.040。结论切断胰腺显露受累门静脉法简单、安全,对于有门静脉浸润的胰头癌,可以显著提高手术切除率,延长患者远期生存时间。
Objective To investigate the role of the pancreas transection and portal vein exposure in promoting resection rate for pancreatic carcinoma and to compare the new procedure with traditional surgery. The clinical significance of palliative resection for pancreatic carcinoma was also discussed. Methods The clinical data of 94 operated cases of portal vein involved pancreatic carcinoma within 10 years were reviewed. 45 cases from Jan. 1997 to mar. 2002 were as traditional surgery group. 49 cases from mar. 2002 to fhay 2007 were as direct pancreas transection group, the pancreas transection and portal vein exposure procedure were used to resect tumor in cases with the tumor invasive to the portal vein. Local radiotherapy and chemotherapy were used in some of cases. All the cases were followed up. Results The overall tumor resection rate in traditional surgery group was 35.56% and it was 65.31% in direct pancreas transection group, P = 0. 0075. The morbidity and mortality rates in both groups were with no significant difference. The survive rates of 6 month, 1 year,3year in the former group were 97.78% ,71.11% ,24. 44% respectively,it were 97.96% ,75.51% , 46. 94% respectively in the later group. The 3 year survival rates of the two groups showed a significant difference, P =- 0. 040. Conclusions The pancreas transection and portal vein exposure is a simple and safe procedure to increase resection rate and prolong survival time for patients with advanced pancreatic carcinoma.
出处
《肝胆外科杂志》
2009年第4期268-270,共3页
Journal of Hepatobiliary Surgery
