胰十二指肠切除治疗壶腹周围癌232例报告

Pancreaticoduodenectomy for Treatment of Periampulla Carcinoma of Vater:232 cases Analysis

目的 总结胰十二指肠切除术的经验教训。方法 对 1961年 6月至 1999年 6月收治的 2 3 2例行胰十二指肠切除术(PD)的胰头及壶腹部肿瘤患者的病例资料 ,进行回顾性分析。结果 术后近期并发症的发生率为 3 5 .8% (83 /2 3 2 ) ,手术死亡率为6.9% (16/2 3 2 )。以 1986年为界 ,将PD手术患者分为 2个阶段进行对照 ,手术并发症从第 1个阶段的 45 .3 % (3 4 /75 )下降至第 2个阶段的 3 1.2 % (49/15 7,P <0 .0 5 ) ,手术死亡率从第 1个阶段的 14 .7% (11/75 )下降至第 2个阶段的 3 .2 % (5 /15 7,P <0 .0 1)。结论 配备有丰富经验的专科医生和完善的外科操作技术是降低手术并发症和手术死亡率的关键。

Objective To summarize the experience and lesson drawn from pancreaticoduodenectomy(PD).Methods 232 PD patients with periampulla of Vater carcinoma between 1961 to 1999 were studied retrospectively.Results Of the 232 patients with PD operation,79 were pancreatic primaries,109 arose in the ampulla,32 were distal bile duct cancers,and 12 were duodenal cancers.There were 35.8% operative complications and 6.9% operative mortality during 38 years of review,with a 45.3% operative complications and a 14.7% operative mortality before 1986,after that,there were 31.2% and 6.9% respectively.Conclusion The decrease of operative complications and mortality rate depends on skilled surgical experts and perfect technique.