联合血管切除的胰十二指肠切除术61例临床分析

Clinical analysis of pancreaticoduodenectomy in combination with vessel resection:a report of 61 cases

目的探讨联合血管切除的胰十二指肠切除术的方法及临床意义。方法回顾性总结61例联合血管切除的胰十二指肠切除术经验。结果联合血管切除的胰十二指肠切除术围手术期死亡率为4.9%(3/61),并发症发生率为18%(11/61)。获随访的47例胰腺癌病人,术后生存5～36个月,平均18个月。有9例血管受侵病人术后存活超过24个月,1例已生存42个月至今,无肿瘤复发。结论严格掌握手术适应证,联合血管切除的胰十二指肠切除术并不增加手术死亡率和并发症发生率,并可在一定程度上延长病人的生存期。

Objective To investigate the methods and significance of pancreaticoduodenectomy in combination with vessel resection. Methods The clinical data of 61 patients receiving pancreaticoduodenectomy in combination with vessel resection in our hospital were retrospectively analyzed. Resuits The mortality and morbidity were 4. 9% and 18%, respectively. The follow-up study showed that the median survival time was 18 months in 47 patients with pancreatic carcinoma. Nine patients with cancer invasion survived for over 24 months after operation and one of them survived for 42 months without tumor recurrence. Conclusions If candidates are carefully selected, pancreaticoduodenectomy in combination with vessel resection can be safely performed without increased mortality and morbidity. Long-time survival can be expected in some cases.