胰腺癌的早期诊断与外科处理

目的 探讨胰腺癌的早期诊断与外科处理。方法 回顾分析24例胰腺癌诊断和治疗情况。结果 24例胰腺癌中，胰头癌19例，胰体尾癌5例；经B超、CT诊断24例，MRI18例，MRCP8例，RECP12例，DSA3例，IOUS11例，FNAB17例；根治性切除4例，胆囊空肠内引流术13例，附加胃空肠吻合术6例，胆囊空肠双造口4例，瘤体内注射无水乙醇6例，胃十二指肠动脉区域化疗8例，PTCD3例。术后胰瘘1例，疼痛缓解18例，黄疸减退／消失14例，死亡1例，其余术后恢复良好。结论 可疑胰腺癌患，联合运用影像学、肿瘤标记物、穿刺检查等方法，才能提高早期诊断率。恰当的外科处理，术后辅助性区域放、化疗和免疫调节治疗，是提高胰腺癌患生存期、降低术后并发症和病死率的必要措施。

Early diagnosis and surgical treatment for pancreatic carcinoma

Objective: To discuss the early diagnosis and surgical treatment for pancreatic carcinoma. Methods: Diagnosis and treatment of pancreatic carcinoma were analysed retrospectively. Results: Among 24 patients of pancreatic carcinoma, 19 were pancreatic head carcinoma,5 were pancreatic body or tail carcinoma; 24 were diagnosed with B-US and CT,18 with MRI,8 with MRCP,12 with EPCP,3 with DSA,11 with IOUS,17 with FNAB;4 were performed radical resection,13 were performed cholecystojejunostomy,6 of 13 cases were performed extra gastrojejunostomy;4 were performed cholecystendysis and jejunostomy,6 were treated with injecting pure ethanol into tumor,8 were cannulated into gastrodudenol artery for regional chemotherapy, 3 were perfomed PTCD. 1 got pancreatic fistula postoperatively,pain was alleviated among 18 cases,jaundice were alleviated or disappeared in 14,1 was dead,the others got well. Conclusion: Improving early diagnosis on pancreatic carcinoma,treating it rationally,performing adjuvant regional radiotherapy and/or chemotherapy as well as immunotherapy are all necessary measures that can improve the survival period of the patients and decrease the complication and mortality postoperatively.