老年胰腺癌患者外科治疗的临床分析

Surgical treatment of elderly patients with pancreatic neoplasm

目的 探讨老年胰腺癌患者的临床表现和治疗及预后。方法 收集 1990～ 2 0 0 0年上海华山医院胰腺癌中心 180例经过手术治疗的老年胰腺癌患者 ,其中 4 6例行Whipple手术 ,包括 2 2例介入治疗后的区域性胰十二指肠切除术 ,观察术后并发症和 30d内的死亡率。 78例接受了姑息手术 ,5 4例仅做剖腹探查术。随访 6个月到 10年。结果 所有患者都成功地进行了手术。 4 8例经外科根治性切除者的死亡率为 6 .2 % ,并发症率为 2 0 .8% ,中位生存期为 2 6个月 ;78例姑息手术者平均存活 6个月 ,5 4例仅行剖腹探查术者平均生存期只有 3个月。结论 外科治愈性手术治疗有助于延长老年胰腺癌患者的生存期 。

Objective To further elucidate the clinical feature, treatment and prognosis of pancreatic cancer in elderly patients. Methods Data of 180 elderly patients with pancreatic cancer operated upon during 1990 2000 were analyzed. Postoperative complications and 30 day mortality rates were recorded among the 46 cases subjective to Whipple procedure, including 22 cases undergoing regional pancreatoduodenectomy after intervention therapy. 78 patients received palliative surgery and 50 patients received laparotomy. Follow up was made for 6 months to 10 years. Results All the patients were operated upon successfully. 48 patients underwent radical pancreatectomy with a mortality rate of 6.2 per cent, a complication rate of 20.8 per cent, and a mean survival period of 26 months. The 78 cases undergoing palliative surgery survived for 6 months on average. 54 patients undergoing laparotomy only survived for 3 months on average. Conclusion Aggressive surgical management helps prolong the survival period and improve the life quality of elderly patients with pancreatic cancer.