摘要
目的：探讨胰头癌根治术加区域淋巴结廓清对提高手术根治效果和生存率的作用。方法：对２１例胰头癌患者在胰十二指肠切除术（Ｗｈｉｐｐｌｅ）基础上，扩大手术切除的范围，有针对性地进行区域淋巴结廓清。分析其临床和病理资料，并进行随访观察。结果：全组无手术死亡及严重并发症发生，有１１例（５２％ ）患者存在淋巴结转移。其中，淋巴结癌转移率以肠系膜根部（１４组）和胰头后（１３组）最高，其次为胰头前（１７ 组）、肝动脉旁（８ 组）和肝十二指肠韧带（１２ 组）。术后３ 例发生轻中度腹泻。随访病例中有１ 例在术后３ 个月因严重腹泻治疗不当死亡，１例术后５ 个月发生肝转移，其余病例均存活。结论：附加区域淋巴结廓清的胰头癌根治术风险并无明显增加，但根治效果良好，存活时间延长，虽尚需进一步扩大样本和延长随访时间，但其前景令人鼓舞。
Objective: To investigate the effect of regional lymphadenectomy in radical resection of adenocarcinoma in the head of pancreas. Methods: We extended the resection area of conventional pancreaticoduodenectomy (Whipple procedure), and removed the regional lymph node around the head of pancreas clearly. From Dec 1996 to May 1999, the radical pancreaticoduodenectomy combined with regional lymphadenectomy was performed on 21 patients with adenocarcinoma in the head of pancreas. The clinical and pathological material were reviewed, and the follow up data was obtained. Results: There was no operative mortality and severe complication in all patients. The light node metastasis occurred in 11(52%) patients. The lymph nodes around the superior mensenteric artery (Group 14) and the posterior pancreaticoduodenal lymph nodes (Group 13) was the predominant metastatic site of the tumor, followed by the anterior pancreaticoduodenal lymph nodes (Group 17), the lymph nodes around common hepatic artery (Group 8) and the lymph nodes in hepatic duodenal ligment (Group 12). Light to moderate diarrhea occurred in 3 patients after operation. One patient died of improper treatment of diarrhea during the 3rd month after operation. There was no death in the other 20 patients in the follow up period. Conclusion: The radical pancreaticoduodenectomy combined with wide resection of regional lymph nodes is a safe and effective procedure in the treatment of the adenocarcinoma in the head of the pancreas. It may improve the prognosis of this disease.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
1999年第11期886-888,共3页
Academic Journal of Second Military Medical University
关键词
淋巴结廓清术
胰十二指肠切除
胰头癌
pancreas neoplasms
regional lymphadenectomy
pancreaticoduodenectomy
