保留幽门的胰十二指肠切除术治疗壶腹周围癌47例报告  

Pylorus-preserving Pancreaticoduodenectomy in Pancreatic and Periampullary Carcinomas(Report of 47 Cases).

作　　者：徐军明[1] 刘颖斌[1] 王家骅[1] 王本茂[2] 

机构地区：[1]浙江大学医学院附属第二医院普外科,310009 [2]第二军医大学东方肝胆外科医院

出　　处：《外科理论与实践》2001年第2期76-78,共3页Journal of Surgery Concepts & Practice

摘　　要：总结保留幽门的胰十二指肠切除术（ＰＰＰＤ）治疗壶腹周围癌的临床效果。方法：将４７例ＰＰＰＤ与同期１２７例经典的胰十二指肠切除术（ＰＤ）作对照研究，分析两组的术后并发症及生存率。结果：ＰＰＰＤ组与ＰＤ组术后并发症发生率分别为３４．０％和２７．６％，其中胃排空延迟发生率分别为８．５％及６．３％，均无显著差异；术后５年生存率分别为４７．３％和４１．４％，无统计学差异。Ⅰ、Ⅱ期肿瘤的５年生存率为５９．３％，而Ⅲ、Ⅳ期肿瘤５年生存率仅为６．８％，两者差异显著（Ｐ＜０．０１）。结论：对于无明显胰外浸润转移的胰头癌及壶腹部癌患者可施行ＰＰＰＤ。To evaluate the results of pylorus-preserving pancreaticoduodenectomy(PPPD) in the treat- ment of selected patients with carcinoma of the head of pancreas or of the periampullary region. Metho- ds: From Dec 1984 to Dec 1999, 174 patients with carcinoma of the head of pancreas or of the periampullary re- gion underwent either PPPD(n=47) or standard pancreaticoduodenectomy (PD, n = 127); short- and long-term results were compared between the two groups. Results: The incidence of post-operative complications was 34.0% in the PPPD group and 27.6% in the PD group, and the rate of delayed gastric emptying as 8.5% and 6.8%, respectively. There were no significant differences in actuarial survival curves between PPPD and PD, the 5- year survival rate was 47.3% after PPPD and 41.4% after PD. But for patients in stages Ⅲ and Ⅳ, the 5-year survival rate was significantly lower as compared to patients of stages Ⅰ and Ⅱ. Conclusions: PPPD might be an acceptable alternative to PD in the treatment of cancer of the head of pancreas or of the periampullary region, if the proximal duodenum or peripyloric lymph nodes were not involved.

关 键 词：胰腺肿瘤 壶腹部肿瘤 保留幽门胰十二指肠切除术 PPPD 

分 类 号：R735[医药卫生—肿瘤]