联合肠系膜上静脉切除的胰十二指肠切除术治疗胰腺癌34例临床分析

Clinical efficacy of superior mesenteric vein resection combined with pancreaticoduodenectomy in the treatment of 34 cases of pancreatic cancer

目的探讨联合肠系膜上静脉切除的胰十二指肠切除术治疗胰腺癌的临床疗效。方法选取68例胰腺癌侵犯肠系膜上静脉(SMV/PV)患者,随机分为对照组和观察组,每组34例。对照组患者采用十二指肠切除术治疗,观察组患者采用联合肠系膜上静脉切除的十二指肠切除术治疗。比较两组患者的病理组织检查及围手术期死亡情况,以及患者术后随访的生存率。结果对照组患者胰腺癌切除率为29.41%,明显低于观察组的79.41%,差异有统计学意义(P<0.05);对照组切除端的癌细胞浸润率为17.65%,术后并发症发生率为35.29%,均明显高于观察组的0及11.75%,差异均有统计学意义(P<0.05);观察组患者随访二年生存率为85.29%,明显高于对照组的52.94%,差异有统计学意义(P<0.05)。结论联合肠系膜上静脉切除的胰十二指肠切除术治疗胰腺癌,能够提高胰腺癌切除率,降低并发症发生率,延长生存期,效果显著,值得临床推广。

Objective To investigate the clinical efficacy of superior mesenteric vein resection combined with pancreaticoduodenectomy in the treatment of pancreatic cancer. Methods Sixty-eight patients of pancreatic cancer invading superior mesenteric vein/portal vein（SMV/PV） were randomly divided into control group and observation group, with 34 patients in each group. The control group was treated with resection of the duodenum, while the observation group was treated with superior mesenteric vein resection combined with pancreaticoduodenectomy. The two groups were compared in pathological examination results, perioperative death, and survival rate. Results The resection rate of pancreatic cancer in the control group（29.41%） was significantly lower than that in the observation group（79.41%）, P〈0.05. In the control group, the tumor cell invasion rate of the removal end was 17.65% and the incidence of postoperative complications was 35.29%, which were significantly higher than those in the observation group（0 and 11.75%）, P〈0.05. During the follow-up of two years, the survival rate of the control group was 52.94%, significantly lower than 85.29% in the observation group（P〈0.05）. Conclusion In the treatment of pancreatic cancer, superior mesenteric vein resection combined with pancreaticoduodenectomy can significantly increase the resection rate of pancreatic cancer, reduce the incidence of complications, and prolong survival rate, which is worthy of promotion.