联合血管切除术在胰头癌治疗中的临床意义(附34例报告)  

Role of pancreaticoduodenectomy with en bloc vascular resection in surgical treatment of pancreatic carcinoma: a report of 34 cases

作　　者：胡志浩[1] 胡先贵[1] 刘瑞[1] 张怡杰[1] 唐岩[1] 王本茂[1] 

机构地区：[1]第二军医大学附属长海医院普外科,上海市200433

出　　处：《中华肝胆外科杂志》2002年第9期543-545,共3页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的　探讨联合血管、胰十二指肠切除术的临床意义。方法　回顾性分析近 10年来34例联合血管、胰十二指肠切除术病例的临床资料。血管切除包括 ,门静脉 (SMV)或肠系膜上静脉(PV)楔形切除 ,SMV或PV切除 ,肠系膜上动脉 (SMA)切除 ,SMV或PV +SMA切除 ,SMV或PV +肝动脉切除。结果　本组病人术后并发症发生率 17 6 5 % (6 / 34) ,主要并发症有胃潴留、上消化道出血、切口裂开等 ,围手术期 (术后 1个月内 )死亡率 8 82 % (3/ 34)。 11例随访病人生存期为 5～ 2 6个月 ,平均 (15 4 4± 7 89)个月。结论　行血管切除有助于提高局部较晚期肿瘤的切除率 ,能明显改善病人的生存质量 ,在一定程度上延长病人的生存期。Objective To determine the clinical value of major vascular resection as part of pancreaticoduodenectomy in surgical treatment of pancreatic carcinoma. Methods The clinical data of 34 patients receiving pancreaticoduodenectomy with en bloc resection of adjacent vascular structure for pancreatic head malignancy in our hospital in the past 10 years were retrospectively analyzed. Vascular resection includes portal vein or superior mesenteric vein (PV/SMV), superior mesenteric artery (SMA), PV/SMV combined with SMA, PV/SMV combined with hepatic artery (HA). Results The postoperative morbidity and mortality were 17 65% (6/34) and 8 82% (3/34), respectively. The major complications were delayed gastric emptying (8 82%) and gastrointestinal bleeding (5 88%). The survival time was 5-26 months (mean=15 44±7.89 months) in 11 cases. Conclusions Major vascular resection can increase the resection rate, improve life quality and extend the patients' survival time.

关 键 词：胰头癌 胰腺肿瘤 胰十二指肠切除术 血管切除 血管侵犯 

分 类 号：R735.9[医药卫生—肿瘤]