老年胰头癌外科诊治分析

The analysis of diagnosis and surgery treatment in old pancreatic head cancer patients

目的 分析老年胰头癌的临床表现、诊治方法,提高老年胰头癌的诊治水平。方法 回顾性分析18例老年胰头癌的临床表现、诊治方法和治疗效果。结果 主要临床表现有上腹部疼痛及不适,梗阻性黄疸。术前B超、CT检查结果主要为胰头占位;胰头增大,变形;肝内外胆管扩张;胰管扩张;双管征等。主要的伴发疾病包括慢性阻塞性肺病,心脏疾病,水、电解质及酸碱平衡紊乱,低蛋白血症等。全组行根治性胰十二指肠切除术3 例(16.67%),肿瘤未切除而行姑息性手术者15例(83.33%)。治愈或好转出院17例,死亡1例。结论 B超、CT联合检查对确立诊断及指导外科治疗有重要意义。老年胰头癌患者伴发疾病多、根治性切除的机会少。围手术期正确的处理是保证手术顺利实施和防止术后并发症的关键。

Objective To understand the feature of pancreatic head cancer in old patient and to improve the level of the disease. Methods To analysis 18 old patients with pancreatic head cancer in symptom, diagnosis, and surgery treatment retrospectively.Results The main symptoms in 18 patients are pain and unfit in the epigastrium and obstructive jaundice.Iconography:the disphlay by B ultra and CT including occupation,expanding and metamorphosis in pancreatic head,dilatation in inter-extern liver duct,pancreatic duct and bouble duct and so on.The main accompany disease in COPD,heart disease,water-electrolyte misbalance and hypoproteinemia et al.The treatment for 3 patients is whilpple (16.67%) ,for the others palliative operation was given (83.33%). 17 patients were cured and another was died.Conclusion There are significant value about B ultra and CT detection in diagnoses and treatment. Too complex and multiple company disease to give a entirely blade treatment in elder pancreatic head cancer. The key point to prevent complicates and success treatment is the correct deal during perioperation.