胰十二指肠切除术在胃癌治疗中的应用

Pancreaticoduodenectomy for the surgical treatment of advanced gastric carcinoma

目的 :探讨胃癌侵犯或累及胰头十二指肠区域的手术治疗选择。方法 :回顾性分析了自 1981年 1月至 2 0 0 0年 12月间收治的 5 1例胃癌侵犯或累及胰头十二指肠的患者的资料。结果 :原发性胃癌 5 1例 ,术式分别为胃次全切除术 2 9例 (SG组 ) ,胃癌根治及胰十二指肠切除术 (PD组 ) 11例和胃空肠吻合术 8例 ,腹腔内肿物活检术 3例。PD组的一、三年生存率为 6 3.6 %和 36 .4 % ,而SG组为 17.2 %和 3.4 % ,PD组的生存率要比SG组明显提高 (P<0 .0 1)。结论 :胃癌侵犯胰头十二指肠区域患者进行胃癌根治联合胰十二指肠切除术是合理和安全的 。

Purpose:To investigate the choice of surgical therapy for the pancreaticoduodenal region invaded by or involved in stomach carcinoma. Methods:51 patients from Jan. 1981 to Dec. 2000 with stomach carcinoma invaded by or involved in the pancreaticoduodenal region were analyzed retrospectively. Results:All patients were primary stomach carcinoma, the operative methods of stomach carcinoma included subtotal gastrectomy (Group SG,n=29), radical Pancreaticoduodenectomy (Group PD,n=11),gastrojejunostomy (n=8) and tumour’s biopsy (n=3). In group PD, one-,and three-year survival rates was 63.6% and 36.4%, in group SG, it was 17.2% and 3.4%. The survival rate of group PD was markedly better than that of group SG respectively (P<0.01). Conclusions:radical Pancreaticoduodenectomy is a rational and safe method for the treatment of gastric carcinoma infiltrating into the pancreaticoduodenal region.[