胰头癌手术治疗的疗效分析.doc

胰头癌手术治疗的疗效分析 艾福录，花向东，刘也夫，林杰，郝志强 ( 辽宁省肿瘤医院肝胆胰腺外科， 沈阳 110044) 【 摘 要】目的: 分析手术治疗的胰头癌患者疗效，进一步探讨胰头癌的手术指征及术式选择。方法 : 回顾性分析 2008-2013 年间通过手术治疗的87 例胰头癌病人的临床治疗资料。结果: 87 例患者中行单纯胰头十二指肠切除术 ( Pancreatoduodenectomy , PD ) 37例，联合门静脉/肠系膜上静脉( PV/ SMV )切除的胰头十二指肠切除术 11 例 ，另外 39 例行姑息性胆肠内引流术。姑息性手术患者全部于1年内死亡，单纯行胰头十二指肠切除组的病人1年及3年生存率分别为59 .5 % 和 27.0%，联合血管切除组1年及3年生存率分别为54.5% 和 27.3% 。 结论: 根治性手术切除是目前所有治疗措施中能够达到治愈的唯一方式，在严格把握手术适应症的前提下开展联合血管切除的根治术可以提高胰头癌根治性切除率和术后生存率。 【 关键词】 胰头癌; 胰头十二指肠切除术; 联合血管切除 Therapeutic effect analysis of Surgical treatment for carcinoma of the head of Pancreas AI Fu-lu, HUA Xiang-dong,et al .The tumor hospital of liao-ning province 【 Abstract】Objective: To analyze therapeutic effect of surgical treatment for carcinoma of the head of pancreas and study the operative indication and model of carcinoma of the head of pancreas. Methods: The clinical data of 87 pantients with carcinoma of the head of pancreas were analyzed retrospectively from 2008 to 2013. Results: 37 patients underwent pancreatoduodenectomy,11 patients underwent pancreatoduodenectomy with PV/SMV resection, palliative hepaticojejunostomy was performed to the rest. All the patients who underwent palliative resection were died in 1 year after the operation, the 1,3-year survival rate of patients undergoing PD wan 59.5% and 239% respectively, the 1,3-year survival rate of patients undergoing PD with vascular resection was 32.4% and 23.1% respectively. Conclusion: PD is the only way to cure carcinoma of the head of pancreas, PD with vascular resection can increase the resection rate and survival on the condition of strict indication. 【 Keywords】 carcinoma of the head of Pancreas ; Pancreatoduodenectomy; PV/SMV 胰头癌是消化系统恶性肿瘤当中预后最差的肿瘤之一 ，而且发现和确诊时绝大部分都已经有局部侵犯和(或) 远处转移，目前手术切除是所有治疗措施中能够达到根治目的的唯一有效手段。现对我科2008-2013年手术治疗的 87 例 胰头癌病人的疗效进行回顾性分析，进一步研究其手术指征及术式选择，提高胰头癌的根治性切除率及手术疗效，评估手术风险及降低手术并发症。 1 临床资料 1.