摘要
目的 :回顾总结上海第二医科大学附属瑞金医院外科 2 0世纪 90年代以来收治的 5 5 6例胰腺癌患者外科治疗的情况 ,探讨如何逐步提高胰腺癌外科手术治疗的安全性和疗效。方法 :1990年 1月～ 2 0 0 0年 12月间普外科收治的胰腺恶性肿瘤5 5 6例 ,其中胰头癌 4 0 3例 ,胰体尾部癌 15 3例 ,将本组病例分成 1990年 1月～ 1995年 12月及 1996年 1月～ 2 0 0 0年 12月两个阶段来对比分析。结果 :行手术治疗 36 7例 ,胰头癌与胰体尾部癌手术切除率分别为 14 .6 %与 14 .4 % ,总手术切除率为14 .6 %。根治性手术死亡率分别为 5 %与 4 .6 % ;手术并发症发生率分别为 37.5 %与 2 2 .7%。根治性手术并发症主要是 :胰瘘、胆瘘、出血、腹腔积液、感染、吻合口梗阻等。 90年代后期 ,胰头癌组在手术切除率有了提高。同时根治性手术并发症发生率及手术死亡率也降低。胰体尾部癌组 ,手术切除率虽无提高 ,但根治性手术并发症发生率及手术死亡率均较前阶段明显降低。结论 :最大限度地提高手术切除率和长期生存率 ,降低手术死亡率。
Objective: Retrospectively analyze the surgical treatment of 556 patients with pancreatic carcinoma admitted in our surgical department during the latest 90's to discuss the improvement of operative safety and therapeutic efficiency of pancreatic carcinoma. Methods: Analysis of the 556 patients diagnosed as pancreatic carcinoma in our surgical department from January, 1990 to December, 2000. Among them, 403 cases with carcinoma of head of pancreas and 153 cases with carcinoma of body and tail of pancreas. Besides, we divided the whole group into two for comparison according to the different period of time, the first period is from January,1990 to December,1995, the second period is from January,1996 to December,2000. Results: 367 patients with pancreatic carcinoma were operated. The resective rate of carcinoma of head of pancreas and carcinoma of body and tail of pancreas is 14.6% versus 14.4%, the total resective rate is 14.6%, the mortality of radical surgery of them is 5% versus 4.6%, as well as the operative complication morbidity is 37.5% versus 22.7%. The main operative complications of this study are pancreatic fistula, biliary fistula, bleeding, abdominal fluid collection , infection and anastomotic obstruction. The data of the second period of carcinoma of head of pancreas group indicates a higher resective rate along with a lower complication morbidity and mortality of radical surgery. Although, the data of that period of carcinoma of body and tail of pancreas group indicates no elevation of resective rate, but achieved a lower complication morbidity and mortality of radical surgery. Conclusion: In order to gradually improve the resective rate and long survival rate, decrease the operative mortality, complication morbidity, the more important key factor, except for the early diagnosis, is that a professional surgeon team should be organized.
出处
《中国临床医学》
2003年第4期453-455,共3页
Chinese Journal of Clinical Medicine
关键词
胰腺癌
外科治疗
并发症
安全性
支持疗法
感染
Carcinoma of head of pancreas Carcinoma of body and tail of pancreas Resective rate Operative complication
