联合门静脉胰腺癌切除术的安全性及疗效评价

目的对联合门静脉切除胰腺癌的可行性进行分析，为胰腺癌的治疗提供新途径。方法以行联合门静脉胰腺癌切除术的病变累及门静脉胰腺癌35例患者为观察组，20例同期行姑息旁路术的同类患者为对照1组，同期病灶未累及门静脉行标准根治手术的20例胰腺癌患者为对照2组，观察3组的手术效果及并发症情况。结果采用联合门静脉切除胰腺癌患者的手术后并发症发生率为25％，与对照2组的23．5％相比差异无统计学意义（P〉0．05）；对患者采用寿命表进行计算，观察组患者术后1、3、5年的生存率分别为78．5％，28．8％，9．58％，与对照2组的80．5％，30．9％以及10．23％的差异无统计学意义（均P〉0．05），但显著高于对照1组的48．5％，11．5％，1．5％（均P〈0．05）。结论对于病变已累及门静脉的胰腺癌采用联合门静脉胰腺癌切除术，可有效提高胰腺癌手术切除率，有效延长患者寿命，改善患者预后。

Safety and clinical evaluation of pancreaticoduodenectomy with portal vein resection

Objective To analyze the feasibility of pancreaticoduodenectomy with portal vein resection, in order to provide a new therapeutic approaches for treatment of pancreatic cancer. Methods Taken 35 cases of portal vein metastasis patients who recieved pancreaticoduodenectomy with portal vein as observation group; taken 20 cases of portal vein metastasis patients who recieved palliative surgery as control group 1 ; taken 20 ca- ses of portal vein non-metastasis patients who recieved pancreaticoduodenectomy as control group 2. We ob- served the effects and complication rates of these 3 groups. Results The incidence of complications of observa- tion group was 25% , had no significant difference compared with control group 2 （P 〉 0.05 ）. 1-year, 3-year and 5-year survival rate in observation group were significantly higher than that in control group 1 （P 〈 0.05 ）, and had no significant difference compared with control group 2 （ P 〉 0.05 ）. Conclusions For portal vein me- tastasis pancreatic cancer patients, carry out pancreaticoduodeneetomy with portal vein resection could effective- ly improve the surgical resection rate, prolong life and improve prognosis.