目的 探討原發(fā)性十二指腸乳頭癌的診斷及外科治療方法。方法 回顧性分析2002年1月至2008年12月期間經(jīng)手術(shù)治療的54例原發(fā)性十二指腸乳頭癌患者的臨床資料。結(jié)果 行纖維十二指腸鏡檢查37例,行ERCP檢查35例,準(zhǔn)確率均為100%。44例行胰十二指腸切除術(shù),10例行姑息性減黃手術(shù)。手術(shù)均順利完成,術(shù)后出現(xiàn)胰漏6例,腹腔及切口感染2例,出血2例,肺部感染1例,漏膽1例?;颊咝g(shù)后1、3及5 年的累積生存率分別為68%、50%及29%。結(jié)論 纖維十二指腸鏡及ERCP是診斷十二指腸乳頭腫瘤最有效的檢查方法, 早期診斷、早期選擇合理的根治性切除手術(shù)是治療的關(guān)鍵。
引用本文: 淦宇,李寧,魯穩(wěn)柱. 原發(fā)性十二指腸乳頭癌的診斷及治療. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(12): 1299-1301. doi: 復(fù)制
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12. | Sewnath ME, Karsten TM, Prins MH, et al. A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice [J]. Ann Surg, 2002; 236(1): 17-27. |
13. | Lai EC, Doty JE, Irving C, et al. Primary adenocarcinoma of the duodenum: analysis of survival [J]. World J Surg, 1988; 12(5): 695-699. |
14. | Joesting DR, Beart RW Jr, van Heerden JA, et al. Improving survival in adenocarcinoma of the duodenum [J]. Am J Surg, 1981; 141(2): 228-231. |
- 1. Allema JH, Reinders ME, van Gulik TM, et al. Results of pancreaticoduodenectomy for ampullary carcinoma and analysis of prognostic factors for survival [J]. Surgery, 1995; 117(3): 247-253.
- 2. 成東華摘譯. 小腸腫瘤的TNM分期 [J]. 中國實用外科雜志, 2006; 26(12): 927.
- 3. Klempnauer J, Ridder GJ, Pichlmayr R. Prognostic factors after resection of ampullary carcinoma: multivariate survival analysis in comparison with ductal cancer of the pancreatic head [J]. Br J Surg, 1995; 82(12): 1686-1691.
- 4. Howe JR, Klimstra DS, Moccia RD, et al. Factors predictive of survival in ampullary carcinoma [J]. Ann Surg, 1998; 228(1): 87-94.
- 5. Beger HG, Treitschke F, Gansauge F, et al. Tumor of the ampulla of Vater: experience with local or radical resection in 171 consecutively treated patients [J]. Arch Surg, 1999; 134(5): 526-532.
- 6. Talamini MA, Moesinger RC, Pitt HA, et al. Adenocarcinoma of the ampulla of Vater. A 28-year experience [J]. Ann Surg, 1997; 225(5): 590-599.
- 7. Duffy JP, Hines OJ, Liu JH, et al. Improved survival for adenocarcinoma of the ampulla of Vater: fifty-five consecutive resections [J]. Arch Surg, 2003; 138(9): 941-948.
- 8. Sperti C, Pasquali C, Piccoli A, et al. Radical resection for ampullary carcinoma: long-term results [J]. Br J Surg, 1994; 81(5): 668-671.
- 9. Alexakis N, Halloran C, Raraty M, et al. Current standards of surgery for pancreatic cancer [J]. Br J Surg, 2004; 91(11): 1410-1427.
- 10. Yamaguchi K, Chijiwa K, Shimizu S, et al. Comparison of endoscopic retrograde and magnetic resonance cholangiopancreatography in the surgical diagnosis of pancreatic diseases [J]. Am J Surg, 1998; 175(3): 203-208.
- 11. Ito K, Fujita N, Noda Y, et al. Preoperative evaluation of ampullary neoplasm with EUS and transpapillary intraductal US: a prospective and histopathologically controlled study [J]. Gastrointest Endosc, 2007; 66(4): 740-747.
- 12. Sewnath ME, Karsten TM, Prins MH, et al. A meta-analysis on the efficacy of preoperative biliary drainage for tumors causing obstructive jaundice [J]. Ann Surg, 2002; 236(1): 17-27.
- 13. Lai EC, Doty JE, Irving C, et al. Primary adenocarcinoma of the duodenum: analysis of survival [J]. World J Surg, 1988; 12(5): 695-699.
- 14. Joesting DR, Beart RW Jr, van Heerden JA, et al. Improving survival in adenocarcinoma of the duodenum [J]. Am J Surg, 1981; 141(2): 228-231.