局部切除治疗T_1和T_2期Vater壶腹癌的临床观察  

Local resection for T_1–T_2 carcinoma of the ampulla of Vater

作　　者：陈继业[1] 蔡守旺[1] 董家鸿[1] 

机构地区：[1]中国人民解放军总医院肝胆外科,北京100853

出　　处：《中国普通外科杂志》2014年第3期283-286,共4页China Journal of General Surgery

摘　　要：目的:探讨局部切除术在Vater壶腹癌治疗中的价值。方法:回顾性分析1997—2005年间收治的63例T1、T2期Vater壶腹癌患者临床资料,其中21例行局部切除(观察组),42例行胰十二指肠切除(对照组)。比较两组手术时间、术中出血量、术中输血量、术后并发症、术后住院时间及术后生存情况。结果:两组患者临床病理资料具有可比性(均P>0.05);与对照组比较,观察组平均手术时间、术中出血量、术中输血量、术后并发症发生率均明显降低(均P<0.05),但平均住院时间差异无统计学意义(P>0.05);两组术后生存率差异无统计学意义(P=0.131)。结论:局部切除术治疗T1、T2期Vater壶腹癌创伤小、并发症发生率低、术后生存率满意。Objective： To assess the value of local resection in treatment of carcinoma of the ampulla of Vater. Methods： The clinical data of 63 patients with T1 or T2 ampullary carcinoma treated between the years of 1997 and 2005 were retrospectively analyzed. Of the patients, 21 cases underwent local resection （observational group）, while 42 cases were subjected to pancreaticoduodenectomy （control group）. The operative time, intraoperative blood loss, intraoperative blood transfusion, incidence of postoperative complications, and length of hospital stay as well as postoperative survival between the two groups were compared. Results： The clinicopathologic data of the two groups were comparable （all P〉0.05）. In observational group compared with control group, the average operative time, intraoperative blood loss, intraoperative blood transfusion, and incidence of postoperative complications were significantly reduced （all P〈0.05）, while the average length of hospital stay showed no statistical difference （P〉0.05）. There was no statistical difference between the two groups in postoperative survival （P=0.131）. Conclusion： Local resection causes less trauma and has a lower incidence of postoperative complications than pancreaticoduodenectomy in treatment of T1 or T2 ampullary carcinoma, and with favorable postoperative survival.

关 键 词：肿瘤 肝胰管壶腹 胰十二指肠切除术 局部切除术 

分 类 号：R657.5[医药卫生—外科学]