原发性十二指肠癌32例诊断与治疗  

Diagnosis and Treatment of 32 Cases of Primary Duodenal Cancer

作　　者：刘吉宝[1] 魏毓龙[1] 崔凯[1] 

机构地区：[1]新乡市中心医院肿瘤外科,新乡市453000

出　　处：《医药论坛杂志》2006年第16期29-30,共2页Journal of Medical Forum

摘　　要：目的总结原发性十二指肠癌的诊断和治疗方法。方法对32例原发性十二指肠癌进行回顾分析。结果临床表现包括腹痛、黄疸、上消化道出血等;术前确诊率十二指肠镜加气钡造影为95%、十二指肠镜92.3%、气钡造影为78.5%、CT为66.6%;18例行胰十二指肠切除,4例行节段切除,切除率68.7%(22/32)。10例行旁路手术31.3%(10/32),胰十二指肠切除术后1、3、5年生存率分别为90%、40%、20%,行旁路手术术后1年生存率为0。结论原发性十二指肠癌缺乏特异性症状,十二指肠镜、气钡造影等联合检查可提高术前诊断率。治疗首选胰十二指肠切除术。肿瘤较小、患者高龄或合并有其他内科基础病可考虑节段性切除。Objective To summarize the diagnosis and treatment methods of primary duodenal cancer. Methods 32 cases of primary duodenal cancer were retrospectively analyzed. Results The clinical manifestations of primary duodenal cancer were abdominal pain, jaundice and alimentary tract hemorrhage, etc. The correct preoperative diagnostic rate by different examinations were as follow： duodenal endoscopy combined with air barium double radiography 95 % , duodenal endoscopy 92.3 % , air barium double radiography 78.5% and CT 66.6%. Pancreaticoduodenectomy were performed for 18 cases, segmental duodenectomy for 4 cases, with a resection rate of 68.7% （22/32）. Bypass operation were performed for 10 cases（31.3% , 10/32）. The 1,3,5 year survival rates for patients with pancreaticoduodenectomy were 90% ,40% ,20% respectively. There was no 1 - year survival for patients with bypass operation. Conclusion Patients with primary duodenal cancer lack specific symptoms and signs, duodenal endoscopy combined with air barium double radiography can improve the preoperative positive diagnotic rate. The therapy choice should be pancreaticoduodenectomy for patients with primary duodenal cancer. Segmental duodenectomy can be used for small tumor,elder or patients who complicated with other basic diseases.

关 键 词：十二指肠癌 十二指肠镜 手术治疗 

分 类 号：R735.31[医药卫生—肿瘤]