局部切除术及胰十二指肠切除术治疗十二指肠乳头中、高分化腺癌的对比研究  

A comparative study of local excision and pancreaticoduodenectomy for duodenal adenocarcinoma

作　　者：沈曦温 唐哲[1] 赵永福[1] 吴阳[1] 张弓[1] 陈旭[1] 赵坤[1] 

机构地区：[1]郑州大学第一附属医院肝胆外科,郑州450052

出　　处：《腹部外科》2014年第4期289-291,共3页Journal of Abdominal Surgery

基　　金：河南省教育厅项目（13A32041）

摘　　要：目的对比研究局部切除术与胰十二指肠切除术治疗十二指肠乳头中、高分化腺癌的安全性与有效性。方法收集2002年3月至2012年9月局部切除术（A组）的十二指肠乳头中、高分化腺癌的患者21例，行胰十二指肠切除术（B组）的患者28例，回顾分析其临床资料。结果A组患者住院时间（21．4±5．7）d，手术时间（128．3±22．2）min，腹腔引流液淀粉酶（1693．1±1608．9）U／L，术中出血量（119．5±45．1）ml明显低于B组（28．1±8．1）d，（240．6±31．3）min，（4879．1±4730．2）U／L，（295．6±151．1）ml，P均〈0．053。A组发生吻合口瘘2例，B组发生吻合口瘘10例（P〈0．05），两种手术方式生存率差异无统计学意义（P〉0．05）。结论局部切除术与胰十二指肠切除术在十二指肠乳头中、高分化腺癌治疗中的远期疗效相似，但局部切除术围手术期并发症发生率低、具有更高的安全性。Objective To compare the safety and effectiveness of local excision and pancreati- coduodenectomy in patients with duodenal adenocarcinoma. Methods A total of 49 patients with well differentiated duodenal papilla adenocarcinoma were collected from March 2002 to September 2012 at our hospital. They underwent local excision （n = 21, group A） and pancreaticoduodenectomy（n = 28, group B）. Retrospective analyses were performed for all clinical data. Results The hospitalization time （21.38 ± 5.67 days）, operative duration （128.29 ± 22. 16 min）, peritoneal fluid amylase （ 1693. 14 ± 1608. 92 U/L）and amount of bleeding （119. 48 ± 45.14 ml） were significantly less in group A than those in group B（28.14 ± 8. 12 days, 240. 61 ± 31.28 min, 4879. 11 ± 4730. 18 U/L, 295.61 ± 151.13 ml, P〈0. 05）. Anastomotic fistula occurred in 2 patients in group A versus 10 in group 13. No significant inter-group difference existed in survival rate （P〉0. 05）. Conclusions The long-term effi- cacies are comparable for pancreaticoduodenectomy and local excision for well-differentiated duodenal papilla adenocarcinoma. However, local excision is safer with a lower rate of perioperative complica

关 键 词：腺癌 胰十二指肠切除术 对比研究 

分 类 号：R735.9[医药卫生—肿瘤]