联合肠系膜上静脉切除的胰十二指肠切除术治疗胰腺钩突部癌  

The role of the pancreatoduodenectomy combined with superior mensenteric vein resection in the treatment of the pancreas uncinate process carcinoma.

作　　者：裴永泉[1] 李森[1] 王建立[1] 宋钦华[1] 

机构地区：[1]潍坊市人民医院肝胆外科,261041

出　　处：《中国实用外科杂志》2001年第10期610-611,共2页Chinese Journal of Practical Surgery

摘　　要：目的　探讨累及肠系膜上静脉 (SMV)的胰腺钩突部癌手术切除时 ,联合SMV、门静脉 (PV)切除的手术方法、操作要点 ,以提高切除率。方法　总结 1990年 1月至 2 0 0 0年 6月手术切除累及SMV的胰腺钩突部癌 8例 ,合并PV、SMV切除、重建的经验。其中 5例切除静脉干长度为 2 0～ 4 2cm ,直接对端吻合 ,3例行受浸润血管侧壁切除修补术。结果　 1例术后 3天肝功能衰竭死亡 ;1例未行脾静脉与SMV吻合者 ,术后出现乳糜样腹水 ,经治疗 40天痊愈 ,术后存活 2 0个月 ;5例术后生存 13～ 2 9个月 ;1例术后已 3个月 ,无癌肿复发。结论　胰腺钩突部癌的门静脉浸润不是根治手术禁忌证 ;联合PV。Objective To explore the method and the main point of the resection of pancreas uncinate process cancer invading the superior mensenteric vein(SMV)and to improve the resection rate of the pancreas uncinate process carcinoma.Methods To sum up the resection and re-construction experience of 8 patients of pancreas uncinate process cancer invading SMV and portal vein(PV) during Jan.1990 to Jun.2000 including 5 cases who underwent PV trunk and SMV resection of 2 0～4 2cm,and underwent successfully end-to-end anastomosis directly,other 3 cases who underwent PV lateral wall partial resection.Results 1 case died of hepatic failure 3 days after operation.1 case without undergoing splenic vein and SMV anastomosis,got serious chylous ascites,lasting 40 days,and was cured eventually,the survival time was 20 mouths.The other 5 cases was 13 to 29 mouths.1 case lives for 3 months without cancer recurrence.Conclusion The pancreas uncinate process carcinoma invading the portal vein is not the contraindication of the pancreatoduodenectomy,combination with the resection of portal vein can improve the resection rate.

关 键 词：胰腺癌 钩突部 肠系膜上静脉 胰十二指肠切除术 治疗 手术治疗 

分 类 号：R735.9[医药卫生—肿瘤]