壶腹部周围癌肝转移行胰十二指肠根治术联合肝移植的临床初步报告  

Primary clinical report on periampullary carcinoma with multiple hepatic metastases treated by liver transplantation and radical pancreatoduodenectomy

作　　者：彭承宏[1] 沈柏用[1] 邓侠兴[1] 刘一云[1] 陈皓[1] 祝哲诚[1] 谢俊杰[1] 李宏为[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科瑞金医院器官移植中心,上海200025

出　　处：《外科理论与实践》2008年第1期53-56,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨壶腹部周围癌肝转移者行胰十二指肠根治术(Whipple术)联合肝移植的可行性和效果。方法:3例壶腹部周围癌肝转移病人行Whipple术联合原位肝移植术。Whipple术均采用常规胰肠吻合、胆肠吻合和胃肠吻合重建消化道;肝移植术中,2例为经典式,1例为背驮式;术后采用免激素方案并进行常规化疗(吉西他滨、5-FU和CF)。结果:3例均成功实施Whipple术联合肝移植,术后早期恢复好,且生活质量好。病例1和病例2分别于术后5个月、7个月出现肿瘤复发转移,生存期为8个月和15个月。病例3术后4个月因误服致肝损的中药而肝衰竭死亡,未发现肿瘤复发转移。结论:Whipple术联合肝移植是壶腹部周围癌肝转移者可考虑的治疗方法,其疗效还有待进一步研究。Objective To evaluate the feasibility and outcome of periampullary carcinoma with multiple hepatic metastases treated by liver transplantation and radical pancreatoduodenectomy,Methods Three cases of periampullary carcinoma with multiple hepatic metastases treated by orthotopic liver transplantation and radical pancreatoduodenectomy, The radical pancreatoduodenectomy included pancreaticojejunostomy,hepaticojejunostomy and gastrojejunostomy as reconstruction,For the liver transplantations, one was of the piggy-back type and two were of the classic type, Immumosuppression without hormone and routine chemotherapy were used after operation,Results All 3 patients had uneventful recovery from the operation, Case 1 and Case 2 had recurrence and metastases 5 months and 7 months after operation, their survival time was 8 months and 15 months respectively,Case 3 died of liver failure 4 months after operation. Conclusions Liver transplantation and radical pancreatoduodenectomy is a mode of treatment to be considered for patients suffering from periampullary carcinoma with multiple hepatic metastases, Further study is needed to confirm the beneficial effect of this mode of treatment.

关 键 词：壶腹部周围癌 肿瘤转移 肝移植 胰头十二指肠切除术 

分 类 号：R735.0[医药卫生—肿瘤]