摘要
目的：总结胰头癌及壶腹周围癌患者行胰十二指肠切除术（PD）或姑息性手术术前患者病情差异及术后并发症、死亡率和长期生存率的比较。方法：对73例胰头癌及壶腹周围癌患者实施PD 32例（PD组）和姑息性手术41例（姑息性手术组）,对这些病例进行回顾性分析。结果：PD组术后发生各种并发症者19例,发生率为59.4%,死亡率为6.2%（2/32）,术中、术后均通过病理诊断证实为恶性肿瘤,其中14例胰腺导管腺癌,2例壶腹部癌,13例十二指肠癌,3例胆总管下端癌,术后患者平均IC U治疗时间为（1.06±0.25）d,平均总住院时间为（33.88±14.59）d。姑息性手术组术后各种并发症发生者9例,发生率为22.0%,无患者术后死亡,病理诊断39例胰腺导管腺癌,2例十二指肠癌,平均总住院时间为（25.20±10.34）d。姑息性手术组生存时间3.53~4.47个月,平均生存时间为（4.00±0.24）个月;PD组生存时间14.10~17.53个月,平均生存时间为（15.82±0.88）个月。两组平均生存时间差异有统计学意义（P〈0.05）。结论：胰十二指肠切除术与姑息性手术相比,虽然术后并发症发生较多,但患者远期生存率明显提高,在严格手术指征下,是目前治疗胰头癌及壶腹周围癌的唯一有效治疗方式。
Objective： To compare the preoperative clinical condition, postoperative complication and long-termsurvival in patients underwent pancreaticoduodenectomy（PD） or palliative surgery as the treatment for periampullary carcinomas. Method： Clinical data of 32 cases underwentpancreaticoduodenectomy and 41 cases underwentpalliative surgery for the treatmentof periampullary carcinomas fromJanuary 2006 to December 2010 were collected and analyzed retrospectively. Results： Data of Preoperative clinicalcondition from2 groups were statistically indifferent. In PD group, Postoperative complication occurred in 19 cases, the mobidity was 59.3%, the mortality was 6.2（n=2）. The histologic diagnosis confirmed 14 cases of pancreatic ductalcarcinomas, 2 cases of ampullary carcinomas, 13 cases of duodenalcarcinomas and 3 cases of cholangiocarcinomas. The average period staying in ICU was（1.06±0.25）days, the average staying in hospital was 33.88±14.59 days. Compared to PD group, postoperative complication in palliative surgery group occurred in9 cases, the morbidity was 22.0%. No patients died after surgery treatment. The average staying in hospitalwas（25.20±10.34）days. The histologic diagnosis confirmed 39 cases of pancreatic ductal carcinomas, 2 cases of duodenal carcinomas. Patients underwent palliative surgery for periampullary carcinomas were living no more than 1 year. The average survival time of patients underwent pancreaticoduodenectomy or palliative surgery was（15.82±0.88）months and（4.00±0.24）months respectively（P〈0.05）. Conclusion： Although the morbidity of patients after pancreaticoduodenectomy was high compared to patients after palliative surgery, but the long-termsurvival was much more optimistic. Pancreaticoduodenectomy was the only effective way to treat periampullary carcinomas when applied to the strictindication.
出处
《中国现代普通外科进展》
CAS
2015年第3期196-201,共6页
Chinese Journal of Current Advances in General Surgery
关键词
胰十二指肠切除术
壶腹周围癌
胰头癌
Pancreaticoduodenectomy
Pancreatic head carcinoma
Periampullary carcinoma
