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十二指肠乳头癌的诊断与外科治疗:附48例报告 被引量:5

Diagnosis and surgical treatment of carcinoma of duodenal papilla :a report of 48 cases
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摘要 目的 探讨十二指肠乳头癌的诊断及治疗效果。方法 回顾分析收治的 48例十二指肠乳头癌患者的临床资料。黄疸 43例 ,上腹疼痛 2 3例 ,皮肤瘙痒 12例 ,其他症状 7例。B超、CT及ERCP检查确诊率分别为 3 9.6% ,5 0 .0 %和 93 .3 %。 3 9例行胰十二指肠切除术 (其中 1例为保留幽门术式 ) ,5例行胆肠和 /或胃肠吻合术 ,1例行肿瘤局部切除 ,3例确诊后自动出院。结果 随诊 3 6例。胰十二指肠切除术后生存期超过 1a者占 66.7% ( 2 4/3 6) ,超过 3a者 3 0 .6% ( 11/3 6)。胰十二指肠切除术 8例中有 2例术后 7年至今仍存活。 3例放弃手术治疗者无 1例生存期超过 1a。行胆肠和 /或胃肠吻合术中仅有 1例生存期超过 1a。结论 ERCP加活检是该病的主要诊断手段 。 Objective To study the results of diagnosis and treatment of duodenal papilla carcinoma. Methods The clinical data of 48 cases of duodenal papilla carcinoma admitted and treated in our hospital during a 7-year period were analyzed retrospectively. The main clinical symptoms included jaundice(43 cases), upper abdominal pain(23 cases), pruritus of skin(12 cases) and other symploms (7cases). The diagnosis accuracy rate of B ultrasound, CT, and ERCP examination were 39.6%, 50.0% and 93.3% respectively. Pancreaticoduodenectomy was performed in 39 cases. (of these, 1 case underwent pylorus-preserving procedure), 5 cases underwent cholecystojejunostomy and/or gastroenterostomy, and 3 were willfully discharged after diagnosis.Results Thirty-six patients were followed up.Survival beyond 1 year and beyond 2 years afer pancreaticoduodeneoctomy were 66.7% and 30.6% (respectively), and 2 cases among 8 cases of 7-year survivors are alive now. But the 3 discharged patients who refused operations lived less than 1 year; and only 1 patient among those who underwent cholecystojejunostomy and/or (gastroenterostomy) lived more than 1 year. Conclusions ERCP plus biopsy are the primary means of diagnosis, and radical resection is the main treatment modality for duodenal papilla carcinoma.
作者 王彬 陈平
出处 《中国普通外科杂志》 CAS CSCD 2004年第10期761-763,共3页 China Journal of General Surgery
关键词 十二指肠肿瘤/诊断 十二指肠肿瘤/外科学 DUODEANAL NEOPLASMS/diag DUODENAL NEOPLASMS/surg
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  • 1Austin JC,Dowar SJ,Neamatallah S.Vaterian cancer in sibling[J].Ann Surg,1998,207(6):655.
  • 2杨维良,张野.壶腹癌,十二指肠乳头癌及胆总管末端癌70例临床分析[J].医师进修杂志,2000,23(3):42-43. 被引量:1
  • 3杨庆康,陈克敏,钟亮.壶腹周围癌的CT和MRI征象分析[J].放射学实践,2000,15(6):399-402. 被引量:12
  • 4Chareton B,Coiffic J,Landen S,et al.Diagnosis and therapy for ampullary tumirs:63 cases[J].Word J Surg,1996,20(6):707.
  • 5汤肇猷.现代肿瘤学[M].第2版.上海:复旦大学出版社,2003.1138.
  • 6汤肇猷.现代肿瘤学[M].上海:上海医科大学出版社,1993.847.
  • 7Monson JRT,Dononhue JH,McEntee Gp,et al.Radical resection of carcinoma of the ampulla of vater[J].Arch Surg,1991,126(2):353-357.
  • 8Farowk M,Niotis M,Branum GD,et al.Indications and the technique of local resection of the papilla of vater[J].Arch Surg,1991,126(4):650-652.
  • 9Hamada N,Tanak K,Ishizki N,et al.A long-term surviving patient with cancer of papilla of vater after local resection[J].Hepatobiliary Pancreatic Surg,1998,54(4):459-462.

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  • 1原春辉,刘永锋,何三光.原发性十二指肠肿瘤86例的诊断和治疗[J].中国普通外科杂志,2005,14(10):757-759. 被引量:17
  • 2杜晓辉,李荣,蒋彦永,陈凛.十二指肠乳头癌的诊断与外科治疗[J].中国普通外科杂志,2006,15(2):134-136. 被引量:12
  • 3胡振华,徐骁,梁廷波,郑树森.胰腺实性-假乳头状瘤的临床诊治[J].中华普通外科杂志,2006,21(9):679-680. 被引量:6
  • 4刘惠民,吴文新,薛秀伟.大肠腺瘤异型增生及癌变的潜在危险因素分析[J].中国全科医学,2006,9(23):1952-1954. 被引量:1
  • 5Delcore R,Thomas JH,Forstrer J,et al.Improving re-sectability and survival in patients with primary duodenal carcinoma[J].Am J Surg,2003; 166:626.
  • 6Michelassi F,Errii F, Dawson PJ,etal.Experience with 647 con.secutive the duodenum,ampulla,head of the pancreas,and distal common bile duct[J].Ann Surg,2007;210:544.
  • 7Allema JH,Reinders ME,Gulik TM,e t a l.Results of pancreaticoduodenectomy for ampullary carcinoma and analysis of prognostic factor for survival[ J].Surg,1995,117 (3):247-253.
  • 8Quirk DM,Rattner DW,Fernandez-del Castillo C,et al.Theuse of endoscopic ultrasonography to reduce the cost of treating ampullary tumors [J].Gastrointest Endosc,1997,46 (4):334-337.
  • 9Bosman FT, Carneiro F, Hrutmn RH , et al. World Health Organization classification of turnouts. Pathology and genetics of tumours of tile digestive system[ M ]. 4th ed. l,yon: IARC Press, 2010.81 -92.
  • 10Kang SP, Saif MW. Ampullary amt periampullary tumors: translational eftbrts to meela challenge in diagnosis aml treatment. [J]. JOP, 2011, 12(2) : 123 - 125.

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