胰腺癌合并胆总管十二指肠瘘9例临床分析

Clinic analysis of 9 cases with choledochoduodenal fistula associated with pancreatic carcinoma

目的探讨胰腺癌合并胆总管十二指肠瘘(choledochoduodenal fistula,CDF)患者的临床特点。方法回顾性分析9例胰腺癌合并CDF患者的临床资料,并总结胰腺癌并发CDF的原因,诊断及治疗。结果9例患者中误诊者6例,占66.7%;同时合并胆石症者6例,占66.7%。9例患者中行手术探查者6例,其中仅1例行胰十二指肠切除术,占全组11.1%。全组随访1～14个月,非根治术者中位生存期为3.6个月。结论胰腺癌合并CDF患者病情重,死亡率高,获得良好预后的关键仍取决于早期明确诊断。

[Objective] To explore the clinical features of choledochoduodenal fistula （CDF） associated with pancreatic cancer. [Methods] Clinical information about 9 cases of CDF associated with pancreatic cancer were analysed retrospectively to summarize pathogenesis, diagnosis measures and treatment methods. [Results] Among all the patients, 6 （66.7%） patients were misdiagnosed, 6 （66.7%） patients were combined with cholelithiasis. 6 patients wero performed laparotomy, only one patient was operated on pancreato-duodenectomy, the radical cure rate was 11.1%. The follow-up with all the patients were made from one month to fourteen months, the median survival time of the patients without radical operation was 3.6 months. [Conclusion] The patients with CDF associated with pancreatic cancer have severe situation and high mortality, and the favourable prognosis may be depended on early accurate diagnosis.