335例壶腹周围癌手术分析

目的 我院近十年来开展的335例壶腹周围癌的手术情况，以期能为逐步提高其外科手术治疗的安全性和疗效提供有益帮助。方法 分析1990年1月至1999年12月间在我院普外科施行手术的335例壶腹周围癌患的临床资料，其中胰头癌237例，壶腹部癌98例。结果 胰头癌与壶腹部癌手术切除率分别为13．5％与66．3％，总手术切除率为29％，根治性手术死亡率为7．69％与5．45％，手术并发症发生率分别为26．9％与32．7％。本组手术并发症主要是：胰瘘、胆瘘、出血、腹腔感染、吻合口梗阻。结论 要最大眼度地提高壶腹周围癌的手术切除率和长期生存率，降低手术死亡率、并发症发生率，除了提高早期诊断率以外，更重要的是一支专业手术组医师梯队的建立。

An analysis of the surgical treatment of peri-ampullar carcinoma with 335 cases.

Objective Analyze the surgical treatment of 335 patients with peri-ampullar carcinoma operated in our hospital during the latest decade to discuss the improvement of operative safety and therapeutic efficiency of peri-ampullar carcinoma. Methods Retrospectively analysis of the clinical materials of 335 patients diagnosed as peri-ampullar carcinoma operated in our department from January, 1990 to December, 1999. Among them, 237 cases with carcinoma of head of pancreas and 98 cases with carcinoma of ampulla. Results The total resective rate is 29%, the resective rate of carcinoma of head of pancreas and carcinoma of ampulla is 13. 5% and 66. 3% , the mortality of radical surgery is 7. 69% and 5. 45%, the operative complication morbidity is 26. 9% and 32. 7%, respectively. The main operative complications in this group are pancreatic fistula, biliary fistula, bleeding, abdominal infection and anastomotic obstruction. Conclusions In order to gradually improve the resective rate and long survival rate, decrease the operative mortality, complication morbidity, the more important key factor, except for the early diagnosis, is that a professional surgeon team should be organized.