胰十二指肠合并肠系膜上静脉-门静脉切除(附25例报告)

Pancreaticoduodenectomy in combination with superior mesentericportal vein resection for adenocarcinoma in pancreas: a report of 25 cases

目的研究胰十二指肠合并肠系膜上静脉-门静脉切除的手术安全性及术后生存率。方法回顾性分析25例因胰腺癌行胰十二指肠合并肠系膜上静脉-门静脉切除病人,根据病理有无真正的血管侵犯分为A、B两组,A组:无真正的血管侵犯,B组:肠系膜上静脉-门静脉侵犯。结果25例胰十二指肠合并肠系膜上静脉-门静脉切除并发症发生率为32.0%,无一例手术死亡,术后1、2年生存率分别为56.0%、28.0%,A、B两组并发症发生率、术后2年生存率无明显差别。结论肠系膜上静脉-门静脉侵犯并非胰腺癌根治术的禁忌证,只要仔细选择病例,合并肠系膜上静脉-门静脉切除可安全施行,并不增加手术并发症和死亡率。

Objective To investigate the morbidity,mortality and survival rate after pancreaticoduodenectomy in combination with en bloc superior mesenteric-portal vein(SMPV) resection for adenocarcinoma in pancreas.Methods Twenty-five patients with adenocarcinoma in pancreas receiving pancreaticoduodenectomy in combination with SMPV resection in our hospital were reviewed.Meanwhile,they were pathologically categorized into 2 groups: group A,compression of the venous wall without true invasion;group B,true vein invasion.Results The morbidity was 32.0% and there was no operative mortality.1-and 2-year survival rates were 56.0% and 28.0%,respectively.There were no significant differences in morbidity and survival rate between the 2 groups.Conclusions If candidates are carefully selected,pancreaticoduodenectomy in combination with SMPV resection can be safely performed without increased morbidity and mortality.However,whether it can improve the survival rate should be further explored.