【摘要】 目的探讨胰头癌根治术中对钩突部不同处理方法对根治效果的影响。方法收集天津医科大学第二医院及天津医科大学肿瘤医院自2014年5月1日至2015年5月31日诊断为胰头癌行胰十二指肠切除术的病人51例,按对胰腺钩突的不同处理方法,将其中充分暴露肠系膜上动脉(SMA)作为观察组(27例),不暴露肠系膜上动脉作为对照组(24例),对根治效果的影响进行回顾性分析。结果行SMA暴露的观察组术后病理报钩突部切缘R1为1例,占本组3.7%;未暴露SMA的对照组钩突部切缘R1为7例,占29.1%,两组具有统计学差异(χ2=4.45,P<0.05)。结论在胰头癌根治术中,应将胰腺钩突附着处,包括肠系膜上动脉根部及右侧的纤维组织一同整块切除,可提高根治的效果。更多还原

【Abstract】 Objective To explore the treatment outcomes of different managements for uncinate process in the radical operation of pancreatic head carcinoma. Methods The 51 cases of pancreatic head carcinoma patients undergoing pancreaticoduodenectomy being admitted from May 2014 to May 2015 in The second Hospital of Tianjin Medical University and Tianjin Medical University Cancer Institute and Hospital were divided into two groups,included the groups adequate exposed to superior mesenteric vein( SMV) and splenic vein( SV) with or without exposed to superior mesenteric artery( SMA) and the retrospective analysis of these cases were performed. Results The pathological reports of the cut of the uncinate process showed 1 cases in the group performed SMA exposed operation were R1,taking up 3. 7% of the total cases. The pathological reports of the cut of the uncinate process showed 7 cases in the group performed SMA unexposed operation were R1,taking up 29. 1% of the total cases. The difference in the two groups is significant( χ2=4. 45,P < 0. 05). Conclusion In the radical operation of pancreatic head carcinoma,the adhering tissues of uncinate process included the root of SMA and fibrous tissue on the right side should be excised together with the pancreatic cancer tissues,which improves the prognosis of the operation.更多还原