十二指肠乳头癌的诊断与外科治疗.pdfVIP

15 2 Vol. 15 No. 2 2006 2 Chinese Journal ofGeneral Surgery Feb. 2006 : 1005- 694 ( 2006) 02- 0134- 03 杜晓辉, 李荣, 蒋彦永, 陈凛 ( 解放军总医院 普通外科, 北京 100853) : 10 1 ( 5 ) ( 10 ) ( 4 ) 96. 8% , ( ERCP) 10 0. 0% , ( MRCP ) 83. 3% , B 85. 9% , CT 2. 3% 4 6 ( W hipple ) , 22 , 3 W hipple 3 4 3. 9% 44. 4% ; 5 31. % 33. 3% ERCP, MRCP , : /; / : R 3 5. 3 1 : A D iagnosis and surgical treatm ent of duodenal papilla carcinom a DU X iao-hu i, LI Rong, JIANG Yan-yong, CHEN Lin ( D ep artm ent of General S urg ery , the General H osp ital of PLA , B e ij ing 100 853, Ch ina ) Abstract: Objective To investigate the early diagnosis and treatm ent of duodenal pap illa carcinom a. M ethods The clinical data of 1 patients w ith duodenal pap illa carcinom a were analyzed retrospectively. R esults Pain less jaund ice ( 5 cases) , d iscom fort of upper abdom en ( 10 cases) and hemorrhage of upper d igestive tract ( 4 cases) w ere the in itial m ain clinical sym ptom s. The correct d iagnostic rate for preoperative exam inations were: ERCP in 10 0% , duodenoendoscopy in 9 6. 8% , MRCP in 8 3. 3% , BUS in 85. 9% and CT in 2. 3% of cases. Forty- six cases underwent pancreatoduodenectom y, 22 cases received local resection, and the rem ain ing 3 cases w ere treated by palliative surgery. The 3-year survival rate of W h ipp le operation and local resection was 4 3. 9% and 4 4. 4% respectively, and the 5-year survival rate was 31. % and 33. 3% respectively. Conclusions Duodenoendoscopy, ERCP and MRCP are the m ajor effective d iagnostic m ethods for duodenal pap illa carcinom a. Early d iagnosis and early selection of rational radical operation are essential for successu l treatm ent of