摘要
目的 评价局部切除术在壶腹部肿瘤治疗中的作用。方法 1987年 11月～1998年 12月为 17例乏特氏壶腹部肿瘤患者行肿瘤局部切除 ,其中良性腺瘤 3例 ,腺癌 14例。全部病例均经病理证实。分别采用 2种手术方法行肿瘤切除 ,16例行经十二指肠切开肿瘤切除术 ,1例行经胆总管下段肿瘤切除术。结果 本组术后发生胆道感染 3例 ,无手术死亡。 17例中 12例 (70 .6 % )获得随访 ,随访时间 4～ 6 1个月 ,中位时间 12个月。本组良性肿瘤 3例中 ,1例 17个月因其它疾病死亡 ,2例随访 38,7个月后仍健康存活。恶性 14例中随访 9例 (6 4 3 % ) ,生存≥ 1年者 6例 (6 6 .7% ) ,生存 2年 4例 (44 .4% ) ,生存 5年 2例(2 2 .2 % ) ;另 3例现已分别存活 9,8,6个月 ,仍健在。结论 局部切除术具有对病人创伤小 ,出血少 ,恢复快 ,对生理干扰轻的特点。但需有经验的高年资医生进行手术。适合非胰头部起源的壶腹周围肿物、壶腹周围良性肿瘤或病变 ,此外在病人年龄较大或伴有较严重的其它器官疾病的壶腹周围恶性肿瘤病人 ,在无周围浸润及淋巴结转移情况下也可行局部切除。对非典型性增生 ,术前。
Objective To evaluate the effect of local resection for the tumor of Vater ampulla. Methods seventeen cases of Vater ampullary tumor were subjected to tumor local resection from November 1987 to December 1998, including 3 adenomas and 14 adenocarcinomas confirmed by pathology. Two methods of excision for the tumor were performed, including through duodenum to perform the tumor local resection in 16 cases, and through common bile duct in 1 case. Results Bile duct infection occurred in 3 cases. There was no death in this series. 12 of the 17 cases (70.6%) had been followed up for 4～61 months, median survival time was twelve months. In three benign cases ,one died with another disease 17 months postoperatively, two still alive well 38 and 7 months after operation respectively. In 14 malignancy, 9 cases (64.3%) had been followed up. Of the 9 cases, 6(66.7%) alived ≥ 12 months, 4 (44.4%) 24 months, two(22.2%) 60 months. Conclusions Local resection of the Vater ampulla tumor has advantages, such as small damage ,less bloodlass, quick recovery and less interference of the body, but it must be performed by rich experienced surgeons. It is suitable for patients with a small benign tumor, or in the high risk patients whose carcinoma showed no invasion or metastasis, and it also can be performed in patients such as those with atypical hyperplasia and suspious malignant tumor.
出处
《中国普通外科杂志》
CAS
CSCD
2001年第4期339-342,共4页
China Journal of General Surgery
关键词
胆总管肿瘤
外科学
瓦特氏壶腹
腺癌
CONMON BILE DUCT NEOPLASMS/surg
VATER PAPILLA/surg
ADENOCARCINOMAS/surg
