胰腺癌的扩大切除术

Extended resection for pancreatic carcinoma.

目的 提高胰腺癌的根治性切除率。方法 对 16例胰腺癌施行扩大切除术 ,即以Whipple术或胰体尾部切除为基础 ,广泛清扫区域淋巴结 ,部分并受侵门静脉和 (或 )肠系膜上静脉 (PV/SMV)联合切除。结果 平均手术时间 8 5h。平均术中输血 12 5 0mL。 14例合并受侵PV/SMV联合切除。 11例 (6 8 8% )获根治性切除。术后发生并发症 7例 (4 3 8% )。围手术期死亡 1例 (6 2 5 % )。平均住院时间 35d。获根治性切除的 11例中 ,生存 1/ 2～ 1年者 2例 ,1～ 2年者 8例 ,1例已存活 32个月 ,无复发迹象。结论 胰腺癌的扩大切除术是安全可行的。单纯侵犯PV/SMV的胰腺癌仍有 2 /

Objective In order to enhance the curative resectability rate of pancreatic carcinoma.Methods Sixteen consecutive patients received an extended resection,which is referred to systemic dissection of regional lymph nodes and combined resection of the diseased PV/SMV based on traditional Whipple operation or the distal pancreatectomy.Results Mean operation time was 8 5 hours.Mean intraoperative blood infusion was 1250mL.The procedure was considered curative in 11(68 8%) and palliative in the other five.Postoperative complications occurred in 7(43 8%).Perioperative death occurred in one patient(6 25%).Median length of hospital stay was 35 days.In nine patients undergoing curative resection,two cases survived for 1/2～1 year,six patients survived for 1～2 year and another patient has survived for more than 32 months without evidence of recurrence.Conclusion Extended resection for pancreatic cancer is technically feasible and two-third of pancreatic carcinoma invading PV/SMV alone can be expected to obtain curative resecetion.