多脏器联合切除治疗胰腺体尾部癌18例报告

Combined Multiple organ resection in 18 Patients with Adenocarcinoma of the Body and Tail of Pancrea

目的 探讨多脏器联合切除治疗胰腺体尾部癌的效果。方法 对 1999— 2 0 0 0年 18例多脏器联合切除胰腺体尾部癌病人的临床资料进行分析。结果 胰腺体尾部原发癌 8例和转移癌 10例 ,均接受包括胰腺体尾部和脾脏在内的多脏器联合切除。同时切除的脏器包括 :结肠脾区或左半结肠 14例、部分胃或全胃 8例、直肠 2例、小肠和左肾各 1例 ,无手术死亡 ,2年存活率 2 2 %。原发癌术后平均生存 5月 ,无 1例存活超过 1年 ;转移癌平均存活 35月 ,2年存活率 4 4 %。结论 胰腺体尾部、脾脏和周围脏器联合切除的并发症和死亡率是可接受的。胰腺体尾部原发性癌预后差 ,但转移癌预后较好 。

Objective To review the therapeutic results of combined multiple organ resection in patients with adenocarcinoma of the body and tail of pances.Methods The clinical and pathological data were analyses retrospectively in 18 consecutive patients with adenocarcinoma of the body and tail of pancrea from Aigust 1990 to August 2000.Results Primary pancreatic cancer and extrapancareatic malignancy were in 8 and 10 cases respectively.Distal pancreatectomy with splenectomy was carried out in all.The other organs including left colon in 14 cases,stomach in 8 cases,rectum in 4 cases,small bowel in 1 case and left kidney in 1 case,were resected.There was no operative mortality and 2 year survial rate was 22%.The median survival time of the patients with primary pancreatic cancer was 5 months and no case survived over 1 year.The median survival time of the patients with extrapancreatic malignancy was 35 months and 2 year survival rate was 44%.Conclusion Distal pancreatectomy can be performed with a low rate of mortality and a few of cases with metastatic pancreatic cancer can obtain long term survival.