【摘要】 我院最近21年间,手术治疗胰头癌和壶腹周围癌共351例(胰头癌211例,壶腹周围癌140例)。手术包括胰～十二指肠切除72例(20.5%),内引流术183例(52.2%),剖腹探查活检96例(27.3%)。在72例胰～十二指肠切除手术中有1例手术死亡,手术死亡率为1.3%,用我们改良的胰～十二指肠切除术式,术后并发症和死亡率明显下降。壶腹周围癌的切除率(40%)比胰头癌(7%)高,且切除后平均生存时间也比胰头癌长;故对壶腹周围癌应首选胰～十二指肠切除术,对不能切除的胰头+应作内引流术。更多还原

【Abstract】 During the past 21 years (1962--1982), 351 cases with cancers of thehead of pancreas and periampullary region had been operated on in ourhospital. These cases gave the following distribution: 211 pancreatic heaand 140 periampullary region (96 cases of Vater’s ampullary cancer, 25cases of carcinomas of the terminal common bile duct, and 29 cases of thetumours of descending part of duodenum). Pancreatico-duodenectomy,for72 acses (20.5%)and the internal biliary drainage for 183 cases (52.2%)and the remaining cases(27.3%) were treated only with exploration forbiopsy. Of the 72 cases of the pancreatico-duodenectomy, one case died duringthe operation, and the mortality of operation was 1.3%. After improvingour procedures of pancreatico-duodenectomy,the post operative complicationsand the mortality decreased markly, because our modified procedures couldprevent pancreatic fistula and acute hemorrhage of upper alimentary tractafter operation.Our resection rate of periampullary cancers (40%) was higherthan that of cancers of the head of pancreas (7%). The average survival ofperiampullary cancers was longer than that of cancers of the head of panc-reas. Therefore we favour the one-stage operation of pancrea tico-duodenc-tomy as the first choice for periampullary cancers, and as to the head ofpancreas inoperable with radical resection we may prefer the internal biliarydrainage to others.更多还原