扩大淋巴结清扫术在胰腺十二指肠切除术中的价值

The value of enlarged lymph node dissection in pancreaticoduodenectomy

目的探讨胰十二指肠切除扩大淋巴结清扫术治疗胰头癌的临床意义。方法选取2010年1月至2018年12月因胰头癌在本院行胰腺十二指肠切除术的55例患者,根据术中淋巴结清扫范围分为标准组(n=22)与扩大组(n=33)。标准组行胰腺十二指肠切除手术及标准淋巴结清扫,扩大组行扩大淋巴结清扫。比较两组手术时间、出血量、住院时间、术后并发症及术后生存时间。结果两组术后并发症发生率比较差异无统计学意义。两组术中出血量、术后平均住院时间比较差异无统计学意义。两组手术时间、淋巴结清扫个数比较差异具有统计学意义(P<0.05);但两组患者1、3、5年生存率比较差异无统计学意义。结论扩大淋巴结清扫并不增加手术并发症发生率和死亡率,但不能明显提高患者的生存期。

Objective To investigate the clinical significance of pancreaticoduodenectomy and enlarged lymph node dissection for the treatment of pancreatic head cancer.Methods 55 patients who underwent pancreaticoduodenectomy for pancreatic head cancer in our hospital from January 2010 to December 2018 were included in the study.According to the scope of intraoperative lymph node dissection,the patients were divided into standard lymph node dissection(n=22)and expanded lymph node dissection group(n=33).The patient's operation time,bleeding volume,hospitalization time;postoperative complications,including pancreatic leakage,bile leakage,postoperative bleeding,abdominal abscess,delayed gastric emptying,etc.;and postoperative survival time were analyzed.Results There was no significant difference in the postoperative complication rate between the two groups.There was no statistically significant difference between the two groups in intraoperative blood loss and he average hospital stay.The difference in operation time and the number of lymph node dissections between the two groups was statistically significant(P<0.05);however,there was no significant difference in the 1,3,and 5-year survival rates between the two groups.Conclusion Expanding lymph node dissection does not increase the complications and mortality of the operation.