【摘要】 目的 对比研究局部切除术与胰十二指肠切除术治疗十二指肠乳头中、高分化腺癌的安全性与有效性。方法 收集2002年3月至2012年9月局部切除术(A组)的十二指肠乳头中、高分化腺癌的患者21例,行胰十二指肠切除术(B组)的患者28例,回顾分析其临床资料。结果 A组患者住院时间(21.4±5.7)d,手术时间(128.3±22.2)min,腹腔引流液淀粉酶(1693.1±1608.9)U/L,术中出血量(119.5±45.1)ml明显低于B组[(28.1±8.1)d,(240.6±31.3)min,(4879.1±4730.2)U/L,(295.6±151.1)ml,P均<0.05]。A组发生吻合口瘘2例,B组发生吻合口瘘10例(P<0.05),两种手术方式生存率差异无统计学意义(P>0.05)。结论 局部切除术与胰十二指肠切除术在十二指肠乳头中、高分化腺癌治疗中的远期疗效相似,但局部切除术围手术期并发症发生率低、具有更高的安全性。更多还原

【Abstract】 Objective To compare the safety and effectiveness of local excision and pancreaticoduodenectomy in patients with duodenal adenocarcinoma.Methods A total of 49 patients with welldifferentiated duodenal papilla adenocarcinoma were collected from March 2002 to September 2012 at our hospital.They underwent local excision(n = 21,group A) and pancreaticoduodenectomy(n= 28,group B).Retrospective analyses were performed for all clinical data.Results The hospitalization time(21.38 ± 5.67 days),operative duration(128.29 ± 22.16 min),peritoneal fluid amylase(1693.14 ± 1608.92 U/L) and amount of bleeding(119.48 ± 45.14 ml) were significantly less in group A than those in group B(28.14±8.12 days,240.61±31.28 min,4879.11 ± 4730.18 U/L,295.61±151.13 ml,P<0.05).Anastomotic fistula occurred in 2 patients in group A versus 10 in group B.No significant inter-group difference existed in survival rate(P>0.05).Conclusions The long-term efficacies are comparable for pancreaticoduodenectomy and local excision for well-differentiated duodenal papilla adenocarcinoma.However,local excision is safer with a lower rate of perioperative complications.更多还原