结肠癌致十二指肠结肠瘘的手术处理

Surgical management of duodenocolic fistula by colonic carcinoma

目的 :探讨结肠癌致十二指肠结肠瘘的手术处理方法。方法 :11例结肠癌致十二指肠结肠瘘患者施行右半结肠切除同时行瘘口切除 ,十二指肠成形术 2例 ,十二指肠壁部分切除十二指肠空肠侧侧吻合术 3例 ,十二指肠段部分切除十二指肠空肠端侧吻合术 4例 ,胰十二指肠切除术 2例。结果 :无手术死亡 ,无吻合口瘘和肠瘘 ,11例均获随访 ,其中 8例存活 2年以上。结论 :对结肠癌致十二指肠结肠瘘采取积极合理的扩大切除 ,同时依据分型正确处理十二指肠创面 ,有助于减少术后并发症和术后复发 ,延长生存期 。

?Objective:To probe surgical management of duodenocolic fistula caused by colonic carcinoma.Methods:All of the 11 cases with duodenocolic fistula by colonic carcinoma underwent right hemicolon resection and at the same period 2 cases underwent fistula resection and duodenoplasty;3 cases underwent part resection of duodenal wall and side-to-side jejunoduodenostomy;4 cases underwent part resection of duodenum end-to-side jejunoduodenostomy and 2 cases underwent duodenopancreatectomy.Results:There were no mortality\,anastomotic leak and intestinal leak in perioperative period.Among 11 cases followed-up,8 cases survived for more than two years.Conclusions:It should be contributive to reduce complications and recurrence rate,prolong the survival time and improve life quality for active and reasonable expand resection and at the same time management of duodenal focus according to the type. 〔