原发性十二指肠恶性肿瘤84例临床分析  

Clinical analysis of primary malignant tumors of the duodenum:84 cases

作　　者：林浩铭[1] 李波[1] 

机构地区：[1]四川大学华西医院普外二科,四川成都610041

出　　处：《中国现代普通外科进展》2003年第4期243-245,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的 :探讨十二指肠恶性肿瘤的常见临床表现、诊断及治疗。方法 :回顾性分析 1995～ 2 0 0 2年84例原发性十二指肠恶性肿瘤的临床资料。结果 :肿瘤主要分布于十二指肠第二段 (6 1/ 84 ) ,病理类型以腺癌为主 (72 / 84 ) ,位于乳头附近的肿瘤常引起胆道梗阻 ,其他部位的肿瘤主要表现为高位肠梗阻或消化道出血。胃镜确诊率达到 78.9% ,十二指肠镜确诊率达到 83% ,CT确诊率达到 84 %。 5 0例行胰十二指肠切除 ,2 0例行短路手术 ,7例行局部切除 ,手术切除率为 70 % (5 7/ 81)。胰十二指肠切除术并发症发生率 18% ,其他术式较少发生并发症。结论 :十二指肠恶性肿瘤症状无特异性 ,内镜和CT是重要的诊断手段 。Objective: To investigate clinical manifestations,diagnosis and therapy for primary malignant duodenal tumors(PMTD).Methods:The data of 84 cases PMTD confirmed by pathology admitted during 1995-2002 in Huaxi Hospital of Sichuan University was restropectively analyzed.Results:Tumors mostly located in the descending portion of the duodenum(61/84).Adenocarcinoma predominates among primary malignant duodenal tumors(72/84).The symptoms of biliary obstruction were caused mostly by tumors around peripapillary region,while GI hemorrhage and intestinal obstruction were caused mainly by tumors in other regions.The accurate diagnostic rates of gastroscopy,duodenoscopy and CT were 78.9%,83% and 84% respectively.Fifty cases underwent pancretoduodenectomy,7 cases segmental duodenetomy,20 cases bypass,so the total resection rate were 70%(57/81).The incidence rate of complications in patients with pancretoduodenectomy was nearly 18%,while other procedures had lower complications.Conclusion: Malignant duodenal tumors have no characteristic manifestations.CT and endoscopy are the mainstays for the diagnosis of PMTD.Pancretoduodenectomy should be the preferential procedure for PMTD.

关 键 词：十二指肠肿瘤 内窥镜检查 胰头十二指肠切除术 

分 类 号：R735.31[医药卫生—肿瘤]