Appleby手术治疗恶性胰体尾肿瘤六例报告

目的探讨胰体尾肿瘤整块切除联合腹腔干切除(Appleby手术)的安全性及可行性。方法对6例接受Appleby手术的侵犯腹腔干的胰腺肿瘤患者的临床资料进行分析。结果6例患者中。5例为原发性胰体尾癌,1例为胰体尾转移瘤(腹膜后神经鞘瘤术后),行胰体尾肿瘤整块切除联合腹腔干切除术,均未行血管重建。6例手术均获得成功。手术时间4～6 h,术中出血400～1200 ml,术后肝功能一过性升高,经保肝治疗,2周内全部恢复正常,肝脏和胆囊均有正常动脉血供,无手术死亡,无严重并发症发生。结论胰体尾肿瘤整块切除联合腹腔干切除手术是安全可行的,它可以提高肿瘤的切除率并可缓解疼痛。

Appleby operation for carcinoma of the body and tail of the pancreas

Objective To investigate the clinical application of Appleby operation for carcinoma of the body and tail of the pancreas.Method The clinical data of 6 Appleby cases were analyzed.Results There were 5 patients with cancer of the pancreatic body and tail,1 patient with metastatic tumor of the pancreatic body and tail undergoing Appleby operation without the need of arterial reconstruction.All operations were successful.Operation time ranged from 4 to 6 hours,Intraoperative blood loss ranged from 400 to 1200 ml.Transient elevated serum level of aminotransferase was noted postoperatively,but it was back to the normal level within 2 weeks.Normal blood supply was not damaged both to the liver and gallbladder.There was neither morality nor severe surgical complications.Conclusion Appleby operation is safe and feasible for carcinoma of the body and tail of the pancreas.It elevates the resectability of the tumor of the pancreatic body and tail and effectively ameliorates the pain caused to the patient.