手术步骤改进治疗壶腹周围癌49例体会  

The surgical treatment of periampullary carcinoma review of 49 cases

作　　者：兰明银[1] 胡玲[1] 张敏[1] 江斌[1] 狄茂军[1] 李恒[1] 

机构地区：[1]湖北省十堰市太和医院普外科,442000

出　　处：《腹部外科》2003年第2期101-102,共2页Journal of Abdominal Surgery

摘　　要：目的　探讨新的诊断和治疗技术对壶腹周围癌外科手术疗效的影响。方法　回顾性分析 1991年 1月～ 2 0 0 2年 3月间我院收治壶腹周围癌 4 9例的手术治疗情况。结果　 4 9例中 ,胰头癌2 6例 ,占 5 3 % ;壶腹癌 11例 ,占 2 2 .4 % ;胆管下端癌 7例 ,占 14 .2 % ;十二指肠乳头癌 5例 ,占 10 .2 %。4 5例行手术切除 ;未能切除的 4例采用胆囊十二指肠吻合术 ,胰头部用微波固化病灶。全组并发胰瘘 2例、腹腔内出血 1例、腹腔感染 1例、消化道出血 1例。术后死亡 2例 ,死于腹腔内出血、腹腔感染、多器官功能衰竭。结论　由于新的围手术期治疗和监护技术的进步 。Objective To evaluate the effect of improved diagnostic and therapeutic strategies on the outcome of patients with periampullary carcinoma undergoing surgical operation.Methods A retrospective analysis of clinical data of 49 cases of periampullary carcinoma 1991.1 to 2002.3 was made.Results Of the 49 patients, 26 were diagnosed as having pancreatic carinoma (PC) (53%), 11 having ampullary carinoma (AC) ( 22.4% ), 7 having distal bile duct cancers (DBDC) ( 14.2% ) and 5 having duodenal cancers (DC) ( 10.2% ). 45 cases received surgical resection, and the remaining 4 cases were subjected to cholecystoduodenostomy and lesions at the head of pancreas were solidified by microwave. In all cases, 2 were complicated with pancreatic fistula, one with intraabdominal bleeding, one with intraabdominal infection and one with hemorrhage of digestive tract. Two cases were died from intraabdominal bleeding, intraabdominal infection and multiple organ failure postoperatively.Conclusion The improved surgical strategies significantly decreased the operative mortality and the incidence of complications in the patients with periampullary cancer.

关 键 词：壶腹周围癌 外科手术 诊断 治疗 疗效 

分 类 号：R735.8[医药卫生—肿瘤]