摘要
目的 探讨联合肠系膜上静脉/门静脉（SMV/PV）切除的胰十二指肠切除术的临床运用价值.方法 对2010年8月～2012年8月期间收治的6例施行联合SMV/PV切除的胰十二指肠切除术的胰腺癌患者的临床资料进行回顾性分析.结果 本组6例胰腺癌患者均成功施行联合SMV/PV切除的胰十二指肠切除术,门静脉切除重建时间均控制在30min内.术后经病理确诊为胰腺癌,均合并有不同程度的SMV/PV血管侵犯,切除后血管及胰腺断端均无肿瘤浸润.术后患者均恢复良好,未出现胰瘘、胆瘘、腹腔出血以及血管栓塞等严重并发症,仅1例发生术后粘连肠梗阻,经再次松解术后痊愈.本组患者住院时间为10～21d,平均14天.截止2013年5月,患者术后生存期6～25个月,平均13个月.目前有4例患者尚存活,且无肿瘤复发征象,其中1例存活时间超过2年.结论 对于肿瘤侵犯SMV/PV但无远处转移的胰腺癌患者,应积极施行手术切除.联合SMV/PV切除的胰十二指肠切除术不仅能够提高胰腺癌的手术切除率,还可明显改善患者的生存质量以及延长患者生存期.
Objective To investigate clinical application of pancreatoduodenectomy with superior mesenteric vein or portal vein （SMV/PV） resection in patients with pancreatic cancer.Methods From August 2010 to August 2012,six patients with pancreatic cancer underwent pancreatoduodenectomy with superior mesenteric vein or portal vein （SMV/ PV） resection in our center,and the clinical data were retrospectively analyzed.Results 1 6 patients in the group underwent pancreatoduodenectomy with superior mesenteric vein or portal vein （SMV/PV） resection.Resection and reconstruction of portal vein were performed in 30 min.The postoperative pathology confirmed the diagnosis of pancreatic carcinoma,SMV/PV had different degree of tumor invasion,and resection of blood vessel and pancreatic stump were free of tumor invasion.All patients recovered without severe postoperative complications as pancreatic fistula,biliary fistula,intra-abdominal hemorrhage and vascular embolism,only one case occurred adhesive intestinal obstruction,and cured after neurolysis.Hospital times were 10～21d,and an average of 14d in this group.Postoperative survival period were 6～25 months till May 2013,and an average of 13 months.Currently,4 cases still survived without tumor recurrence,of which one case survived more than 2 years.Conclusion Patients with pancreatic cancer infiltrating with SMV/PV but without distant metastasis should be suffered with operation.And pancreatoduodenectomy with SMV/PV resection for patients with pancreatic cancer could not only improve operation rate,but also improve the life quality and prolong survival time.
出处
《西部医学》
2013年第11期1683-1685,共3页
Medical Journal of West China
关键词
胰腺癌
胰十二指肠切除术
肠系膜上静脉
门静脉
Pancreatic cancer
Pancreaticoduodenectomy
Superior mesenteric vein
Portal vein
