门静脉切除重建在胰腺癌扩大切除中的应用  

Resection and reconstruction of portal vein in extended rese ction for pancreatic adenocarcinoma

作　　者：骆明德 沈军 吴增斌 费哲为 张一楚 

机构地区：[1]上海市第二医科大学附属新华医院普外科,200092

出　　处：《中国实用外科杂志》2003年第11期674-676,共3页Chinese Journal of Practical Surgery

基　　金：上海市教委科学技术发展基金资助 ( 2 0 0 0B1 1 )

摘　　要：目的　提高局部进展期胰腺癌的根治性切除率并改善其预后。方法　对 1997～ 2 0 0 3年 2 6例单纯侵犯门静脉 (PV )和 (或 )肠系膜上静脉 (SMV )的局部进展期胰腺癌施行受侵PV及SMV在内的整块联合切除术。结果　 16例 (61 5% )获根治性切除 ,10例获姑息切除。围手术期并发症 8例 (3 0 7% ) ,死亡 1例 (3 8% )。获根治性切除的 16例中 ,术后 1、3、5年生存率分别是 68 8% (n =11)、2 6 7% (n =4)和 6 3 % (n =1) ,但姑息切除者术后平均生存仅 5 6个月。结论　对于局部进展期胰腺癌 ,选择合适的病例施行受侵PV及SMV联合切除是安全可行的 。Objective To increase the curative resectability rate and im prove the prognosis of the patients with locally advanced pancreatic adenocarcin oma. MethodsTwenty- six consecutive patients with locally advanced pancreatic adenocarcino ma invading the portal vein(PV) and(or) superior mesenteric vein (SMV) alon e re ceived an en bloc resection, including the diseased PV/SMV . Results Sixteen pat ients (61 5%) underwent curative resection and in the other 10 cases the operat ion was proved histologically to be palliative. Perioperative complication incid ence was 30 7%(n=8) and mortality rate was 3 8%(n=1). In the 16 patients undergoing curativ e resection, 1-year, 3- year, 5- year survival rate was 68 8%(n=11), 26 7%(n=4) a nd 6 3%(n=1) respectively. But the mean survival time was only 5 6 months in pat ients undergoing palliative resection. ConclusionConduction of en bloc resectio n with the invaded PV/SMV is safe and feasible for some screened patients wi th locally advanced pancreatic adenocarcinoma. Patients receiving curative rese ction can be expected to obtain better prognosis.

关 键 词：门静脉切除重建 胰腺癌 扩大切除 治疗 

分 类 号：R735.9[医药卫生—肿瘤]