十二指肠壶腹部癌63例临床分析

Diagnosis and treatment of tumor of duodenal papilla

目的:提高乏特壶腹部癌的早期诊断及治疗水平。方法:回顾性分析自1992年至2009年收治的63例经手术及病理证实的乏特壶腹部癌的临床资料。结果:主要首发临床表现为无痛性黄疽(41例)、消化道症状(18例)及上消化道出血(4例)。术前纤维十二指肠镜检查的检出率为90.9%,逆行性胆胰管造影(ERCP)为100%,磁共振胰胆管成像(MRCP)检查为81.8%,B超检查阳性率为82.5%,CT为88.1%。61例行胰十二指肠切除术(Whipple手术),另2例根据病理检查行局部切除术。结论:ERCP、纤维十二指肠镜是诊断乏特壶腹部癌的有效检查方法,早期诊断、早期选择合理的根治性切除手术是治疗的关键。

Objective：To investigate early diagnosis and treatment of tumor of duodenal papilla.Methods：The clinical data of 63 cases with tumor of duodenal papilla confirmed by operation and pathology from 1992 to 2009 were analyzed retrospectively.Results：The main clinical symptoms were jaundice（41 cases）,digestive tract symptoms（18 cases） and hemorrhage of upper digestive tract （4 case）.The diagnosis rate of FiScroptic duodcnocndoscopy,endoscopic retrograde cholangio pancreaticography （ERCP）,magnetic resonance cholangiopancreatography（MRCP）,type-B ultrasonic（BUS） and CT were 90.9%,100%,81.8%,82.5% and 88.1%,respectively.Sixty-one cases underwent Whipple operation and two cases received local resection.Conclusion：ERCP and FiScroptic duodcnocndoscopy are the most effective methods for diagnosis of tumor of duodenal papilla.It is essential to early select radical resection operation so as to improve the result of surgical treatment.