联合门静脉胰腺癌切除术的安全性及疗效评价

Safety and clinical evaluation of pancreaticoduodenectomy with portal vein resection

目的对联合门静脉切除胰腺癌的可行性进行分析,为胰腺癌的治疗提供新途径。方法以行联合门静脉胰腺癌切除术的病变累及门静脉胰腺癌35例患者为观察组,20例同期行姑息旁路术的同类患者为对照1组,同期病灶未累及门静脉行标准根治手术的20例胰腺癌患者为对照2组,观察3组的手术效果及并发症情况。结果采用联合门静脉切除胰腺癌患者的手术后并发症发生率为25%,与对照2组的23.5%相比差异无统计学意义(P>0.05);对患者采用寿命表进行计算,观察组患者术后1、3、5年的生存率分别为78.5%,28.8%,9.58%,与对照2组的80.5%,30.9%以及10.23%的差异无统计学意义(均P>0.05),但显著高于对照1组的48.5%,11.5%,1.5%(均P<0.05)。结论对于病变已累及门静脉的胰腺癌采用联合门静脉胰腺癌切除术,可有效提高胰腺癌手术切除率,有效延长患者寿命,改善患者预后。

Objective To analyze the feasibility of pancreaticoduodenectomy with portal vein resection, in order to provide a new therapeutic approaches for treatment of pancreatic cancer. Methods Taken 35 cases of portal vein metastasis patients who recieved pancreaticoduodenectomy with portal vein as observation group; taken 20 cases of portal vein metastasis patients who recieved palliative surgery as control group 1 ; taken 20 ca- ses of portal vein non-metastasis patients who recieved pancreaticoduodenectomy as control group 2. We ob- served the effects and complication rates of these 3 groups. Results The incidence of complications of observa- tion group was 25% , had no significant difference compared with control group 2 （P 〉 0.05 ）. 1-year, 3-year and 5-year survival rate in observation group were significantly higher than that in control group 1 （P 〈 0.05 ）, and had no significant difference compared with control group 2 （ P 〉 0.05 ）. Conclusions For portal vein me- tastasis pancreatic cancer patients, carry out pancreaticoduodeneetomy with portal vein resection could effective- ly improve the surgical resection rate, prolong life and improve prognosis.