胰十二指肠切除术123例临床病理学研究

目的：探讨胰十二指肠切除术病例的临床病理学特点，为该术式适应症提供借鉴。方法：对123例胰十二指肠切除术病例的临床及病理资料进行统计、分析，寻找其特点并与临床相联系。结果：123例中十二指肠乳头、Vater壶腹癌67例；胆总管下段癌25例；胰头癌21例；十二指肠乳头旁平滑肌肉瘤1例；胰头及Vater壶腹部NHL 1例；局限性胰腺炎4例；异位胰腺3例；十二指肠乳头部溃疡1例。结论：①重视引起梗阻性黄疸的非肿瘤性疾病与Vater壶腹周围癌的鉴别；②区分Vater壶腹周围癌的组织学来源对指导手术、判断预后十分必要；③重视十二指肠乳头部内镜活检及十二指肠乳头部、Vater壶腹部癌前病变－腺瘤的处理。

Clinical Pathologic Study on 123 Pancreatoduodenctomies

To investigate the clinical Pathologic characteristics of patients underwent pancreatoduodenectomy and to provide reference to the indications of the operation Methods:Case histories of 123 pancreatoduodenctomies were analysed statistically with the clinical and pathologic data.Results:Of the 123 cases,67 were carcinomas of the duodenal papilla and Vater's ampulla,25 were cancers of the distal bile duct,21 cases were cancers from the head of pancreas,also there was 1 case of leiomyosarcoma in the duodenal papilla and 1 case of NHL in the ampulla of Vater;and 4 of localized pancreatitis,3 of ectopic pancreas and 1 of duodenal ampulla ulcer.Conclusion:For patients with obstructive jaundice,it is necessary to differentiate the cancerous diseases from the non cancerous conditions.The histogenesis of cancers in ampulla of Vater should be stressed as well as the endoscopic biopsy and treatment of adenomas in duodenal ampulla.