壶腹部癌局部切除术的疗效评价

THE EVALUATION FOR THE CURATIVE EFFECT OF LOCAL RESECTION OF CARCINOMA OF AMPULLA OF VATER

目的 探讨局部切除术治疗壶腹癌的疗效及合理性。方法 对 1993～ 2 0 0 0年间 15例行壶腹癌局部切除的患者与同时期手术条件相近的行胰十二指肠切除术的 18例壶腹癌患者的治疗效果进行了回顾性对比分析。结果 局部切除术与胰十二指肠切除术两组比较 :并发症分别为 13.3%和 38.8% ,(P>0 .0 5 )。 1年内、2年内、5年内复发率分别为 2 6 .7%、5 3.3%、6 6 .7%和 0、16 .6 %、2 7.8% (P<0 .0 1)。结论 壶腹癌局部切除虽然并发症较少 ,却无法做到根治 ,有较高的复发率 ,远期疗效不佳。

Objective To discuss the curative effect and rationality of local resection of carcinoma of ampulla of Vater.Methods From 1993 to 2000,15 patients with carcinoma of ampulla of vater underwent local resection in our hospital,and 18 patients with same disease and similar operative condition underwent pancreaticduodenectomy.A evaluation of the curative effect was determined between the two groups.Results The rate of complication was 13.3% in group of local resection and 38.3% in group of pancreatic-duodenectomy(P>0.05);The rate of recurrence in 1?2?5 years was 26.7%?53.3%?66.7% and 0?16.6%?27.8% respectively(P<0.01).Conclusion Although the local resection has a low postoperative complication,the operation has a high recurrence.It isn't a radical operation.The long term result is poor.