门静脉切除重建联合胰十二指肠切除术在胰腺癌治疗中的应用
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姜小清

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Application of pancreaticoduodenectomy in combination with portal vein resection and reconstruction in the treatment of pancreatic carcinoma
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    目的:探讨门静脉切除重建联合胰十二指肠切除术治疗胰头癌的临床意义。方法:回顾性分析21例行联合门静脉(PV) 和/或肠系膜上静脉(SMV)、胰十二指肠切除术患者的临床资料,分析手术并发症及其预后。结果:全组围手术期并发症发生率为19.04%(4/21),其中2例胃潴留,1例上消化道出血,1例切口裂开,无胆胰瘘并发症。围手术期(术后1个月内)病死率4.76%(1/21)。20例患者生存期为6~67个月,平均(20.38±9.36) 个月。患者术后1,3,5年生存率分别是65.9%,16.0%和10.2%。结论:有选择的施行血管切除有助于提高局部较晚期胰头癌的切除率,能明显改善患者的生存质量,在一定程度上延长了生存期。

    Abstract:

    Objective:To study the value of pancreaticoduodenectomy in combination with portal vein (PV) resection and reconstruction in the treatment of pancreatic carcinoma.Methods:The clinical data of 21 patients who received pancreaticoduodenectomy in combination with PV resection and reconstruction in the treatment of pancreatic carcinoma in our hospital in the past 6 years were retrospectively analyzed.Results:Perioperative complication incidence was 19.04% (4/21) and mortality rate was 4.76% (1/21). The major complications included delayed gastric emptying (9.52%), gastrointestinal bleeding (4.76%) and disruption of wound (4.76%), but no pancreatic leakage was observed. The survival time of 20 subjects ranged from 6 to 67 months [mean (20.38±9.36) month]. The survival rate at 1y, 3y and 5y of the 21 subjects in this study were respectively 65.9%,16.0%,10.2%.Conclusions:Conduction of en bloc resection with the invaded PV/ SMV is safe and feasible for patients with locally advanced pancreatic adenocarcinoma. Major vascular resection can increase the resection rate, improve life quality and extend patient survival time.

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邱应和, 刘辰, 罗祥基, 易滨, 谭尉峰, 于勇, 冯飞灵, 姜小清, 吴孟超.门静脉切除重建联合胰十二指肠切除术在胰腺癌治疗中的应用[J].中国普通外科杂志,2009,18(3):14-.
DOI:10.7659/j. issn.1005-6947.2009.03.014

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  • 在线发布日期: 2009-03-25