摘要
目的 探讨行壶腹部改良切除术治疗Vater壶腹部周围癌,减少非肿瘤器官切除,提高疗效的手术方法.方法 总结1995～1998年13例壶腹周围癌行扩大壶腹部切除的根治术的经验.经十二指肠后外侧入路,整块切除肝外胆道、胆胰管汇合部,壶腹部及十二指肠乳头.十二指肠乳头封闭术.胆、胰、十二指肠间置空肠或胆、胰空肠Roux-en-y吻合术.结果 围手术期死亡1例.并发症1例经再手术治愈.随访术后半年以上9例,最长生存29个月,无并发症及转移征象.结论(1)该术式符合胰十二指肠解剖关系;(2)按肿瘤治疗原则能达到广泛程度清扫;(3)初行该术式者应掌握胰十二指肠切除术.
Objective: To explore the method of radical surgery of wide ampullecto-my in the treatment of vater ampullary carcinoma, which can decrease excise the normal organ (no infilaration organ) and fit the principle of tumour treatment. Methods: Conclude 13 cases suffered radical surgery of wide ampullectomy in 38 patients of vater ampullary carcinoma and the head of pancreas carcinoma underwent resection treatment during the period from 1995 to 1998.The procedure transperitoneum lateral to the duodenum (kocher's incision), following en block resection of the extra Piliary, confluence of pancreatic and bile ducts, vater ampullary and duodenum pallia, closed the duodenum transversely and undergo jejunum interposed biliary-pancreato-duodenostomy or Roux-en-Y choledocho-pancreato-jejunostomy.Results: Perioperation death occured in 1 case, 1 patient happened to complication and was cured after reoperation.The longest survival period is 29 months without complication and transference. Conclusion: ① Radical surgery of wide ampullectomy fit the anatomy relationship of pancreato-duodenum. ②The lymph node resection range is wide enough to follow the principle of tumour treatment. ③To perform the procedure must grasp the technology of pancreatoduodenectomy.
出处
《中国现代普通外科进展》
CAS
1999年第1期47-49,56,共4页
Chinese Journal of Current Advances in General Surgery
