术中超声引导下射频消融治疗晚期胰体尾癌的临床研究

Clinical study of intra-operative ultrasound-guided radiofrequency ablation for treatment of unresectable carcinoma of pancreatic body or tail.

目的探讨术中超声引导下射频消融治疗晚期胰体尾癌的临床意义。方法对14例手术不能切除的晚期胰体尾癌行术中超声引导下射频消融治疗，观察术中、术后并发症、近期疗效及生存情况。结果所有病例术中均在超声引导下避开大血管进行消融治疗，在超声图中见到胰腺组织明显气化，肉眼观察到胰腺组织明显碳化，病理活检为凝固性坏死。所有病例均无出血、感染、胰瘘等并发症发生，术后癌性腹痛均立即明显缓解，生存期内癌性腹痛完全消失7例，尚能忍受5例，不能忍受2例。平均随访18个月，5例死亡，9例带瘤生存。结论术中超声引导下射频消融治疗晚期胰体尾癌是一种安全有效的姑息性疗法。

Objective To evaluate the clinical efficacy of intra-operative use of ultrasoundguided radiofrequency ablation （US-guided RFA） for the treatment of unresectable carcinoma of pancreatic body or tail. Methods 14 patients with unresectable carcinoma of pancreatic body or tail were treated by US-guided RFA during operation, whose post-operative complications, short-term therapeutic effect and survival were observed. Results US-RFA was successfully performed in all cases, avoiding the major vessels. Ultrasonograms showed that the pancreatic tissue was vaporized markedly. Macroscopic observation witnessed that the pancreatic tissue was carbonized. Pathologic biopsy confirmed that it was coagulation necrosis. All the patients were relieved from epigastric pain after operation, without hemorrhage, infection or pancreatic fistula. Complete remission of epigastric pain was achieved in 7 patients, partial remission in 5 patients, and intolerable pain remained in the remaining 2. During the 18-month follow-up, 5 patients died and the remaining 9 tumor-bearing patients survived well. Conclusions US-guided RFA is an effective and safe treatment for unresectable carcinoma of pancreatic body and tail during operation.