56例原发性十二指肠肿瘤术式选择与分析

The choosing operatic method and analysis of the 56 cases with primary duodenal tumors

目的:了解原发性十二指肠肿瘤的手术治疗方法,探讨原发性十二指肠肿瘤的术式选择。方法:对56例原发性十二指肠恶性肿瘤患者实施标准胰十二指肠切除术(A组,26例),肿瘤局部切除术(B组,14例)和旁路手术(C组,16例),观察三组患者的1、3、5年的生存率,并进行对比。结果:A组26例患者1年生存者22例,占84.6%,3年生存者16例,占61.5%,5年生存者9例,占34.6%;B组14例患者1年生存者8例,占57.1%,3年生存者5例,占35.7%,5年生存者2例,占14.3%;C组16例患者1年生存者2例,占12.5%,无3、5年生存者。A组术后1、3、5年生存率与B组比较,差异有高度统计学意义(χ2=6.27、4.23、3.92,P<0.01);A组术后1、3、5年生存率与C组比较,差异有高度统计学意义(χ2=11.35、8.24、6.81,P<0.01);B组术后1、3、5年生存率与C组比较,差异有高度统计学意义(χ2=5.02、13.42、4.23,P<0.01)。结论:手术治疗原发性十二指肠肿瘤的首选术式是标准胰十二指肠切除术,其次为肿瘤局部切除术,而对于晚期原发性十二指肠肿瘤患者来说,使用旁路手术对改善患者预后有积极意义。

Objective： To acquaint the surgery method and explore the choosing operatic method of primary duodenal tumors. Methods： 56 cases with primary duodenal tumors were treated by standard pancreaticoduodenectomy （group A,26 cases）, local excision （group B,14 cases） and bypass surgery（group C,16 cases）,and to observe the its 1, 3, 5-year survival rates, and compared. Results： Group A of 26 cases 1 year survival in 22 cases, accounting for 84.6%, 3-year survival in 16 cases, accounting for 61.5%, 5-year survival in 9 cases, accounting for 34.6%; group B 1-year survival of 14 patients, 8 cases 57.1%, 3-year survival of 5 cases, accounting for 35.7%, 5-year survival in 2 cases,accounting for 14.3%; group C 1 year survival of 16 cases in 2 cases, accounting for 12.5%, no 3-year survivors.Group A after 1, 3, 5-year survival rate compared with the group B,there was significant differences（χ2=6.27, 4.23, 3.92, P〈0.01）;group A after 1,3,5-year survival rate compared with the group C（χ2=11.35, 8.24, 6.81, P〈0.01）;group B 1,3,5-year survival rate compared with the group C, there were significant differences（χ2=5.02, 13.42, 4.23, P〈0.01）.Conclusion： The standard pancreaticoduodenectomy is the best treatment of the primary duodenal tumors, the secondly is the local excision, but the bypass surgery has a positive means for the terminal primary duodenal tumors.