十二指肠乳头部肿瘤的诊断及治疗:附64例报告  

Diagnosis and treatment of tumor of duodenal papilla:a report of 64 cases

作　　者：任雪峰[1] 黄强[1] 谢放[1] 王世杰[1] 

机构地区：[1]安徽医科大学附属省立医院普通外科,安徽合肥230001

出　　处：《中国普通外科杂志》2009年第1期75-78,共4页China Journal of General Surgery

摘　　要：目的探讨十二指肠乳头部肿瘤的早期诊断及治疗水平。方法回顾性分析收治的64例经手术及病理证实为十二指肠乳头部肿瘤患者的临床资料,包括十二指肠乳头部癌60例,腺瘤4例。结果主要临床表现为黄疸(42例),消化道症状(35例),反复发作的胆管炎(7例)及上消化道出血(1例)。术前ERCP,十二指肠镜,MRCP,BUS,CT检查阳性率分别为100%,97.3%,82.4%,82.8%,76.1%。55例行胰十二指肠切除术,5例行十二指肠乳头局部切除术,4例行姑息性胆肠吻合术。手术并发症发生率16.5%,手术病死率3.6%。行胰十二指肠切除术的癌患者术后1,3,5年生存率为67.4%,40.6%,36.3%。结论黄疸和腹痛是十二指肠乳头部肿瘤的主要症状;十二指肠镜和ER-CP是诊断十二指肠乳头肿瘤最有效的检查方法;早期选择根治性切除手术是治疗的关键。Objective To investigate early diagnosis and treatment of tumor of duodenal papilla. Methods Their clinical data of 64 cases of tumor of duodenal papilla confirmed by operation and pathology were analyzed retrospectively. They included 60 cases of carcinoma of duodenal papilla and 4 cases of adenoma. Results The main clinical symptoms were jaundice （42 cases）, digestive tract symptoms （35 cases ）, recurrent cholangitis （ 7 cases ） and hemorrhage of upper digestive tract （ 1 case ）. The diagnosis rate accuracy of ERCP, Fiberoptic duodenoendoscopy, MRCP, BUS and CT were 100 % , 97. 3 % , 82.4 % , 82. 8 % and 76. 1% respectively. Fifty-five cases underwent pancreatoduodenectomy ,5 cases received local resection, and the remaining 4 cases were treated by palliative surgery. The surgical complication rate was 16. 1% and the surgical mortality rate was 3. 6%. The 1-year, 3-year and 5-year survival rate of pancreatoduodenectomy were 67.4 % , 40.6 % and 36.3 %. Conclusions Jaundice and abdommal pain are the main symptoms of tumor of duodenal papilla. Fiberoptic duodenoendoscopy and ERCP are most effective methods for diagnosis of tumor of duodenal papilla. It is essential to early select radical resection operation so as to improve the results of surgical treatment.

关 键 词：十二指肠肿瘤/诊断 十二指肠肿瘤/外科学 胰十二指肠切除术 

分 类 号：R735.3[医药卫生—肿瘤]