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姑息性手术与胰十二指肠切除术治疗胰头癌合并壶腹周围癌的远期疗效
顾永芳1,2
1.(1)曲靖市第二人民医院肝胆二外科,云南 曲靖 655000;2.2)云南省肿瘤医院结直肠外科,云南 昆明 650000)
摘要:
[摘要]目的 探讨姑息性手术与胰十二指肠切除术治疗胰头癌合并壶腹周围癌远期疗效.方法 选取2002年4月至2014年4月期间来曲靖市第二人民医院进行治疗的胰头癌合并壶腹周围癌患者44例,随机分为观察组和对照组,每组22例,对照组患者采用姑息性手术治疗,观察组患者给予胰十二指肠切除术治疗,比较2组患者手术中出血量、手术时间、总住院时间、并发症、生存期变化、根治切除率及复发率变化情况.结果 与对照组比较,观察组术中出血量增多,手术时间延长,差异有统计学意义(P<0.05);2组住院时间相比,差异不明显(P>0.05);观察组并发症总发生率(54.55%)明显高于对照组(22.73%),差异有统计学意义(P<0.05);观察组患者2 a生存期例数较对照组明显增多,差异有统计学意义(P<0.05);2组患者术后根治切除率及复发进展率比较,差异无统计学意义(P>0.05);结论 与姑息性手术治疗胰头癌合并壶腹周围癌比较,胰十二指肠切除术治疗术中出血量增加,手术时间延长,并发症发生率有所升高,但远期生存率明显提高.
关键词:  [关键词]胰头癌  壶腹周围癌  姑息性手术  胰十二指肠切除术  远期疗效
DOI:
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基金项目:[基金项目]国家自然科学基金项目资助(81560472)
Long-term Effects of Palliative Surgery and Pancreaticoduodenectomy in Treatment of Pancreatic Cancer and Ampulla Surrounding Cancer
GU Yong-fang1,2
1.(1)Dept. of Hepatobillary Surgery,The Scond People's Hospital of Qujing,Qujing Yunnan 655000;2)Dept. of Colon and Rectum Surgery,Yunnan Provincial Tumor Hospital,Kunming Yunnan 650000,China)
Abstract:
[Abstract]Objective To research the long-term effects of palliative surgery and pancreaticoduodenectomy in treatment of pancreatic cancer and ampulla surrounding cancer. Methods Forty-four patients with pancreatic cancer joint periampullary cancer,who were admitted in our hospital for treatment from April 2002 to April 2014, were randomly divided into observation group and control group , with 22 cases in each group. Patients in the control group were treated with palliative surgery,patients in the observation group were treated with pancreaticoduodenectomy treatment. The blood loss,operative time,hospital stay,complications, survival of change,radical resection rate and relapse rate changes of two groups were compared.Results Compared with control group,in the observation group,the blood loss increased, and the time of the surgery extended. And the difference was statistically significant(P <0.05). The hospital stay of patients in the two groups were compared, and there was no significant difference(P>0.05). The overall incidence of complications of the observation group (54.55%)was significantly higher than that of the control group(22.73%),and the difference was statistically significant(P<0.05). The complication rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05). Survival status of the two groups were compared, in the observation group, the number of survival cases during 2 years increased more significantly than that of the control group, and the difference was statistically significant(P<0.05). The radical resection rate after surgery and recurrence rate of the two group were compared, and the difference was not statistically significant (P> 0.05). Conclusions Compared with palliative surgery in treatment of pancreatic cancer joint periampullary cancer, pancreatoduodenectomy treatment may increase the blood loss,extend the operative time and increase the complication rate, but significantly improve the long-term survival rate.
Key words:  [Key words]Pancreatic cancer  Periampullary cancer  Palliative surgery  Pancreaticoduodenectomy  Long-term efficacy