原发性十二指肠腺癌的诊治(附4例报告)

Diagnosis and Treatment of Primary Adenocarcinoma of the Duodenum.A Report of 4 Cases

报告4例原发性十二指肠腺癌。由于本病缺乏特异性症状,仅1例术前作出诊断。症状常与肿瘤的部位有关,早期症状有上腹部胀痛、呕吐、消化道出血及进行性贫血和黄疸。低张十二指肠造影和纤维十二指肠镜检查有助于早期诊断,诊断正确率达93％。胰十二指肠切除或十二指肠部分切除是最有效的治疗方法。本组2例由于发现早作了根治性切除,分别存活9和43个月。

Four cases of primary adenocarcinoma of the duodenum are reported. There were no pathognomonic symptoms. In only one case the diagnosis was made before operation. Symptoms that occurred in the early phase of the disease such as epigastric pain, vomiting, gastrointestinal hemorrhage, progressive anemia and jaundice were related tothe site of the tumor. The performance of roentgenologic hypotonic duodenography and fiberoduodenoscopic examination are helpful in the diagnosis. Pancreatoduodenectomy or partial duodenectomy are the treatment of choice. This radical resections were performed in two patients of this series and survived 9 and 43 months respectively.