壶腹部肿瘤局部切除20例分析  

Clinical application of local excision in treating periampullary tumor:report of 20 cases

作　　者：许邦文[1] 霍宗红[1] 佟艳春[1] 李平[1] 贺登峰[1] 

机构地区：[1]北京军区总医院263临床部普通外科,101149

出　　处：《中华普外科手术学杂志（电子版）》2013年第2期53-55,共3页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨壶腹部肿瘤局部切除的方法和临床效果。方法对20例壶腹周围肿瘤行局部切除术,经十二指肠切除18例,经胆总管下端切除2例,进行回顾性临床分析。结果全组无手术死亡病例,术后并发症发生率15.0%(3/20),3例患者分别为:1例胆漏,1例胰瘘,1例切口感染,均对证处理治愈。良性肿瘤患者随访率60.0%(3/5),其中1例17个月因其它疾病死亡,2例患者术后67个月后仍健康存活。恶性肿瘤患者随访率80.0%(12/15)例。其中生存1年为6例患者(40.0%),生存2年为4例患者(26.6%),生存5年为2例患者(13.3%)。结论局部切除术具有创伤小、出血少、恢复快的特点,适用于非胰头起源的壶腹周围肿瘤或高度怀疑恶变的病例。Objective To investigate the clinical application and outcome of local excision in treating periampullary tumor. Methods Clinical data of 20 patients with periampullary tumor, who underwent local excision, including 18 cases of trans-duodenal resection and 2 cases of resection through the end of bile commen duct, were analyzed retrospectively. Results No patient died from the operation. Postoperative complications occurred in 3/20 patients（ 15.0% ） , including 1 case of biliary leakage, 1 case of pancreatic fistula and 1 case of wound infection. All of complications were cured by conservative treatment. Fifteen patients were followed up. Among these patients, 3 patients had benign tumors （ 1 died 17 months after operation for irrelvant disease, 2 alive within follow-up period） and 12 patients had malignant tumors （postoperative survival： 6 cases inl year （40.0%） , 4 cases in 2 years （26.6%） and 2 cases in 5 years （ 13.3% ）. Conclusion Patients who underwent local excision of periampullary tumor had less invasion, less bleeding and quicker recovery. Based on above advantages, local excision is suitable for patients with non-caput panereatis derived periampullary tumors and those with highly suspectable to canceration.

关 键 词：肝胰管 壶腹肿瘤 胰十二指肠切除术 治疗结果 

分 类 号：R735.0[医药卫生—肿瘤]