高龄壶腹周围癌患者外科诊治分析

Analysis of clinical diagnoses and treatment of periampullary carcinoma in old patients

目的总结高龄壶腹周围癌患者的手术治疗临床经验。方法对227例行手术治疗的70岁以上患者的临床资料进行回顾性分析。结果根治性胰十二指肠切除术89例,姑息性手术138例。根治手术组术后腹腔出血2例,胰瘘3例,肺部感染2例,胃排空迟缓2例。姑息性手术组1例腹腔积液,1例手术后再次出现黄疸,应激性溃疡1例,胃排空迟缓1例。无术后死亡。结论术前积极治疗并存疾病,术中精细熟练操作,术后全面监护防治并发症是高龄壶腹周围癌患者手术治疗成功的保证。

Objective To summarize the clinical experience of operation of periampullary carcinoma in old patients.Methods The clinical data of 227 patients aged over 70 years receiving operation were retrospectively analyzed.Results Eighty-nine cases received pancreaticoduodenectomy and 138 cases received palliative operation.In the pancreaticoduodenectomy group,after operation had 2 cases abdominal hemorrhage and 3 cases had pancreatic leakage,2 cases got pulmonary infection and 2 cases had delayed gastric emptying.In the palliative operation group,after operation,1 case had seroperitoneum,1 case got jaundice,1 case got stress ulcer,1 case had delayed gastric emptying.No death occurred in perioperative period.Conclusions The insurance against the operation for old patients is as follows： active treatment of the coexistent diseases before the operation,exact and skillful manipulation during the operation and the comprehensive prevention of complications after the operation.