胰头癌侵犯胰后大血管的处理  

Surgical treatment for patients with postpancreatic vascular invasion by pancreatic head carcinoma

作　　者：郑英键[1] 邹鸿琪[1] 尹美蓉[1] 

机构地区：[1]湖北省武汉市中心医院普外科,湖北武汉430014

出　　处：《中国普通外科杂志》2002年第3期149-151,共3页China Journal of General Surgery

摘　　要：目的　探讨胰头癌侵犯胰后大血管的治疗方法。方法　采用切除受侵犯血管的根治性胰十二指肠切除术治疗 2 5例胰头癌及 1例复发性十二指肠癌胰后大血管受侵犯者。结果　本组无手术死亡病例。术后发生胰瘘 4例 ,胆瘘 2例 ,均经保守疗法治愈。无血管手术并发症发生。 2 6例获随访2 .5～ 6 .5 (中位时间 4.5 )年 ,平均生存期为 5 6个月 ,1,3,5年生存率分别为 96 .1% ,88.4%和5 7.5 %。结论　 ( 1)彩色多普勒检查可作为术前诊断血管受侵犯的实用、可靠方法。 ( 2 )胰头癌侵犯血管时 ,应积极采用切除受侵犯血管的根治性胰十二指肠切除术。该手术方法合理、安全、有效、可行 ,能提高 5年生存率。Objective To study the method of surgical treatment for patients with postpancreatic vascular invasion by pancreatic head carcinoma. Methods 25 patients with pancreatic head cancer and 1 with recurrent duodenal carcinoma with postpancreatic vessels involved by malignancy were treated by radical pancreatoduodenectomy with involved vascular resection(RPDIVR). Results There was no operation death in the 26 patients.Of the 26 cases, 4 had pancreatic fistula and 2 bile fistula postoperatively, but no vascular complication occurred. All of the 26 patients were followed up for 2.5-6.5 years( median time 4.5 years) and the average survival time was 56 months with 96.1%,88.4%, and 57.5% of 1,3,5 year survival rate. Coclusions (1)Colour Dopper imaging is a more useful and practical method in the preoperative examination of the vessels involved by malignancy. (2)When the postpancreatic vessels are involved by pancreatic head carcinoma, the rational treatment is RPDIVR. RPDIVR is a useful, safe, and an effective method and can improve the 5 year survival.

关 键 词：胰腺肿瘤 外科学 血液供给 胰头十二指肠切除术 胰头癌 

分 类 号：R735.9[医药卫生—肿瘤]