摘要
目的 探讨不同入路行胰十二指肠切除术(PD)治疗胰头癌的临床效果。方法 采集2019年5月至2024年5月医院完成PD治疗的95例胰头癌患者资料,根据PD不同入路分为标准入路组(47例,标准入路下行PD)和前入路组(48例,前入路下行PD)。比较两组手术相关指标、术后病理检查情况、随访6个月时复发情况,记录术后并发症。结果 前入路组术中出血量少于标准入路组(P<0.05)。前入路组淋巴结清扫数目多于标准入路组,R_(0)切除率高于标准入路组(P<0.05)。组间并发症发生率比较,差异无统计学意义(P>0.05)。随访6个月时,前入路组复发率与标准入路组比较,差异无统计学意义(P>0.05)。结论 标准入路PD与前入路PD治疗胰头癌的安全性相当,手术时间及术后恢复情况基本接近,但相较于标准入路,前入路行PD术中出血量少,能提高淋巴结清扫数目和R_(0)切除率。
Objective To investigate the clinical efficacy of different approaches for pancreaticoduodenectomy(PD)in the treatment of pancreatic head cancer.Methods Data of 95 patients with pancreatic head cancer who completed PD treatment in the hospital from May 2019 to May 2024 were collected.According to different PD approaches,they were divided into a standard approach group(47 cases,standard approach down PD)and an anterior approach group(48 cases,anterior approach down PD).The relevant indexes of operation,postoperative pathological examination,recurrence at 6 months follow-up were compared between the two groups,and postoperative complications were recorded.Results The intraoperative bleeding volume in the anterior approach group was less than that in the standard approach group(P<0.05).The number of lymph node dissections in the anterior approach group was higher than that in the standard approach group,and the R_(0) resection rate was higher than that in the standard approach group(P<0.05).There was no significant difference in the incidence of complications between the groups(P>0.05).At the 6-month follow-up,there was no significant difference in recurrence rate between the anterior approach group and the standard approach group(P>0.05).Conclusion The safety of standard approach PD and anterior approach PD in the treatment of pancreatic head cancer is comparable,with similar surgical time and postoperative recovery.However,compared with the standard approach,the anterior approach PD has less intraoperative bleeding and can improve the number of lymph node dissections and R_(0) resection rate.
作者
秦靖宜
李建军
张开明
王辉锋
QIN Jingyi;LI Jianjun;ZHANG Kaiming;WANG Huifeng(Department of General Surgery,the Fifth Clinical Medical College of Henan University of Chinese Medicine(Zhengzhou People’s Hospital),Zhengzhou 450000,China)
出处
《河南医学研究》
2025年第24期4453-4457,共5页
Henan Medical Research
关键词
胰头癌
胰十二指肠切除术
标准入路
前入路
R_(0)切除
复发
pancreatic head cancer
pancreaticoduodenectomy
standard approach
anterior approach
R_(0) resection
recurrence
