保留十二指肠横部的胰十二指肠切除术治疗壶腹周围癌

Panereatoduodenectomy with duodenum of the horizontal part preservation for the treatment of the carcinoma of ampulla of Vater.

作者采用保留十二指肠横部的胰十二指肠切除术治疗壶腹周围癌24例。该法基本同胰十二指肠切除术,但在游离胰头前于横部近肠系膜血管处切断十二指肠,远端闭锁;然后游离胰钩突,切除半胃和胆囊,并横断胆总管和胰体部等。再按 Child 法重建消化道,并加胰胆管置管引流,术后无严重并发症。随访2～10年,5年生存率为58.3%。作者认为本术式适用于无淋巴转移的壶腹部癌、十二指肠乳头癌和胆总管下端癌。较切除空肠上段者有出血少、创伤小和操作简便等优点。

24 patients with carcinoma of the ampulla of Vater were treated by pancreatoduodenectomy with preserva- tion of the duodenum of horizontal part.The digestive tract was reconstructed by Child procedure.There were no severe postoperative complications nor operative mor- tality.5-year survival rate was 58.5% the authors be- lieve that major indicatiions for this procedure include carcinoma of ampulla of Vater,carcinoma of the de- scending duodenum,and carcinoma of the lower end of the common bile duct.