原发性十二指肠腺癌根治40例临床分析

The Clinical Analysis of Primary Duodenal Adenocarcinoma Treated by Operation Resection in 40 Patients

目的探讨原发性十二指肠腺癌(PAD)的诊断和根治术术式选择。方法对我院1985—2002年经手术切除治疗的40例PAD的临床资料进行回顾性分析。结果PAD发病率低,临床表现缺乏特异性,术前内镜确诊率为95%,胃肠X线气钡造影为67%,磁共振胰胆管造影为72.2%,B超为37.5%,MRI/CT为60%。肿瘤位于十二指肠第2段占72.5%。30例行胰十二指肠切除,10例行十二指肠节段切除,切除术后5年生存率分别为47%和43%。结论内镜和X线气钡双重造影是诊断PAD的主要检查方法。早期诊断和根治手术是提高切除率和疗效的主要途径。

Objective To evaluate the preoperative diagnostic procedures and treatment choices of primary duodenal adenocarcinoma (PDA).Methods The clinical data of 40 PDA cases by operation resection from 1985 to 2002 were analyzed retrospectively.Results The morbidity of PDA was low and its clinical manifestation had no characteristics. The correct diagnostic rates of auxiliary examination were: endoscopy of 95%, gastrointestinal X_ray air barium double radiography of 67%, MRCP of 72 2%, BUS of 37 5%, CT/MRI of 60%, The most common location of the adenocarcinoma (72 5%) was at the second portion of the duodenum. Among 40 PDA cases 30 cases underwent pancreatoduodenectomy, 10 cases received segmental deodenectomy, The 5 year's survival rate was 47% and 43% respectively.Conclusions Endoscope and X_ray radiography are mainstays for the diagnosis of PDA.Early diagnosis and radical operation are the major ways to improve the resectable rate and to modify the therapeutic result.