Vater壶腹癌局部切除52例临床分析

探讨总结Ｖａｔｅｒ壶腹癌局部切除的理论依据，复发原因，适应证，术式评价。方法收集并分析国内１９９２－１９９７年报告的４８例和我院经治的４例，共５２例局部切除治疗Ｖａｔｅｒ壶腹癌的临床资料。结果５２例Ｖａｔｅｒ壶腹癌行局部切除术，并发症发生率９．６％，手术死亡率３．８％。随访７个月至８年，１２例复发，其中７例切缘有癌组织残存；低分化腺癌３例，侵袭性腺癌１例；１９例死亡（包括２例手术死亡），余生存８个

Local resection of carcinoma of ampulla of Vater: an analysis of 52 cases

OBJECTIVE: To study the therapeutic results of patients with carcinoma of ampulla Vater treated by local tumor resection. METHODS: Four cases of carcinoma of ampulla of Vater treated in our hospital by local tumor resection and 48 cases reported in Chinese medical literature in 1992-1997 were analyzed. RESULTS: A total of 52 cases was collected who received local resection of carcinoma of ampulla of Vater. The operative mortality was 3.8% and the morbidity was 9.6%. Recurreuce occurred in 12 cases, of whom 3 had poorly differentiated adenocarcinoma, 7 had their tumor incompletely resected with tumor left at the cutting edge and one had local invasion. In 8 month to 4 years, 19 cases died. Thirty two cases survived for 7 months to 8 years after operation. CONCLUSION: The prognosis of local resection is related not only to tumor size, extent of invasion, metastasis to lymph node, but also to pathologic types and differentiation. It is a treatment of choice for early carcinoma of ampulla of Vater in patients who are at high-risk due to old age, poor general condition or severe concurrent diseases.