原发性十二指肠癌的临床特征与手术治疗

Diagnosis and treatment of primary carcinoma of the duodenum: a report of 45 cases

目的 提高原发性十二指肠癌的诊断与治疗水平。方法 回顾性分析我院1987-2000年间收治的45例原发性十二指肠癌的临床资料。结果 乳头周围区癌64.5％（29/45）,乳头下部癌占22.2％（10/45）,乳头上部癌占13.3％（6/45）。十二指肠镜的确诊率为71.4％（15/21）。胰十二指肠切除术22例,节段性肠切除术2例,单纯癌肿切除术3例,胃肠、胆肠吻合术12例,剖腹探查术4例,手术切除率为62.8％（27/43）。结论 原发性十二指肠癌以乳头周围区癌多见。手术以胰十二指肠切除术为主,节段性肠切除术和单纯癌肿切除术根据具体情况可酌情应用。

Objective To improve the diagnosis and treatment of primary duodenal carcinoma. Methods The records of 45 patients with primary carcinoma of the duodenum from 1987 to 2000 were analyzed. Results According to the site of cancer, tumors around, below and above the duodenal papilla accounted for 64.5% (29/45), 22.2% (10/45) and 13.3% (6/45) retrospectively. The diagnosis rate of duodenoscopy was 71.4% (15/21). 22 cases underwent pancreatoduodenectomy, 2 cases underwent segmental duodenectomy, 3 cases underwent simple tumor resection, 4 cases could not undergo curative resection or non - curative operation. The rate of curative resection was 62. 8 % (27/43). Conclusions Parimary duodenal carcinoma occurs mainly around duodenal pailla. The main surgical procedure of primary duodenal carcinoma is pancreatoduodenectomy, segmental duodenectomy and simple tumor resection.