胰腺癌根治术联合门静脉切除的临床应用分析

Clinical application analysis of radical resection of pancreatic cancer combined with portal vein resection

目的探讨胰腺癌根治术联合门静脉切除治疗门静脉受累的胰腺癌患者的疗效。方法选取55例门静脉受累的胰腺癌患者为研究对象,根据手术方式不同,将其分为两组,观察组35例行胰腺癌根治术联合门静脉切除治疗,对照组20例行姑息性旁路手术治疗。所有患者术后均随访5年,观察疗效。结果两组手术时间差异无统计学意义;观察组门静脉阻断时间和术中失血量高于对照组。观察组发生手术并发症11例(31.4%),对照组5例(25.0%),两组并发症发生率差异无统计学意义(P>0.05)。观察组术后1年生存率高于对照组(P<0.05);两组3年、5年生存率差异无统计学意义(P>0.05)。结论当胰腺癌患者门静脉受累时,胰腺癌根治术联合门静脉切除比姑息性旁路手术,可取得更好疗效。

Objective To investigate the therapeutic efficacy of radical resection of pancreatic cancer combined with portal vein resection in the treatment of pancreatic cancer with portal vein invaded.Methods Fifty-five cases of pancreatic cancer with portal vein invaded,who were divided into 2 groups according to their surgical methods,were selected as the objects of study.The observation group（n = 35） received radical resection of pancreatic cancer combined with portal vein resection,while the control group（n = 20） was given palliative bypass surgery.In order to observe the therapeutic efficacy,all patients were followed up for 5 years after treatment.Results The portal vein occlusion time and intraoperative blood loss of the observation group were significantly higher than those of the control group,respectively（P 0.05）,but there were no significant differences in the operation time between two groups（P 0.05）.There were 11 patients（31.4%） in the observation group suffering from operation complications,while there were 5 patients（25.0%） in the control group suffering from operation complications.There was no statistical significance in the operation complications incidence of the two groups（P 0.05）.The postoperative 1-year survival rates of the patients in the observation group were significantly higher than those of the control group（P 0.05）.There was no statistical significance about the 3-year and 5-year survival rates of the patients in both groups（P 0.05）.Conclusion Compared with palliative bypass surgery,the radical resection of pancreatic cancer combined with portal vein resection can obtain better prostecdtive therapeutic efficacy in the treatment of pancreatic cancer with portal vein invaded.