胰头癌的诊断与手术体会（附93例报告）

Diagnosis and Surgical Treatment of Carcino-ma of the Head of the Pancreas

本文总结了９３例胰头癌病人的诊断与手术治疗情况，行胰１２指肠切除１２例，切除率为１３％。文章就如何提高胰头癌的早期诊断率和手术切除率问题进行了探讨，认为上腹部胀痛不适、血清ＣＡ－１９－９测定阳性、Ｂ超及ＥＲ－ＣＰ显示主胰管扩张是胰头癌获得早期诊断的三项主要依据。对三者同时存在的病人应及时部腹探查，如此可提高胰头癌的手术切除率。对进展期病人只要癌肿无远处转移，病人情况允许，均应积极施行胰１２指肠切除术。

3 patients (65 males, 28 fernales, aged25 to 82 years) with carcinoma of the head ofthe pancreas underwent operation in our hos-pital from 1976 to 1992. The main evidencesfor the early diagnosis of this disease consistof upper epigastric pain or flatulence, positiveserum CA- 19- 9, dilated pancreatic duct inB-Ultrsound examination and ERCP. If theseevidences are present, an exploration celioto-my should be performed in order to increasethe rate of resection. The pancreateco-duodenectomv is considered to be still indicat-ed for patients even in advanced stage as longas there is no distant metastases and the gen-eral status of the patients is tolerable for theoperation.