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整块切除含肠系膜上静脉-门静脉的胰十二指肠治疗 II、III 期胰头癌的探讨
引用本文:曾天定,郑樟栋,陈凯,许龙堂,毛根军,罗建生,吴荣进. 整块切除含肠系膜上静脉-门静脉的胰十二指肠治疗 II、III 期胰头癌的探讨[J]. 中华外科杂志, 1997, 0(3)
作者姓名:曾天定  郑樟栋  陈凯  许龙堂  毛根军  罗建生  吴荣进
作者单位:金华市中心医院
摘    要:作者在1989~1995年间收治的28例I、II期胰头癌患者中,对肿瘤侵及肠系膜上静脉-门静脉(SMPV),难以采用标准的胰十二指肠切除(PD)术的15例施行了含SMPV在内的胰十二指肠整块切除。术后并发症发生率53.3%,无围手术期死亡。随访14例中已死亡7例,中位生存期17.1个月。与在此以前因癌肿侵及SMPV而放弃根治切除17例的中位生存期3.8个月进行比较,两组生存期有显著差异(t=8.01,P<0.001)。作者对手术方法和步骤作了介绍,并对本术式的合理性和可行性进行了探讨。作者认为对于I、II期胰头癌病例,如术中发现SMPV受侵而无其他手术禁忌时,施行含SMPV在内的扩大根治术是可行的。

关 键 词:胰腺肿瘤  胰头十二指肠切除术  门静脉  肠系膜静脉

En bloc vein resection in the treatment of pancreatic tumors adherent to the superior mesenteric portal vein confluence
Zeng Tianding,Zheng Zhangdong,Chen Kai,et al.. En bloc vein resection in the treatment of pancreatic tumors adherent to the superior mesenteric portal vein confluence[J]. Chinese Journal of Surgery, 1997, 0(3)
Authors:Zeng Tianding  Zheng Zhangdong  Chen Kai  et al.
Affiliation:Zeng Tianding,Zheng Zhangdong,Chen Kai,et al. Jinhua Municipal Central Hospital,Zhejiang Medical University,Zhejiang 321000.
Abstract:Contraindication is often considered to pancreaticoduodenectomy for patients with malignant tumors of the pancreatic head.From 1989 through 1995, 15 patients with tumors of the pancreatic head adherent to the superior mesenteric portal vein confluence (SMPV) underwent pancreaticoduodenectomy with en bloc resection of SMPV.There was no perioperative mortality.Follow up data showed a mean survival of 17 1 months among 7 deaths, which was significantly longer than an average of 3 8 months among previous 17 patients who abandoned radical resection( P <0 001). We consider that pancreaticoduodenectomy with en bloc resection of SMPV is feasible in some cases.
Keywords:Pancreatic neoplasms Pancreaticoduodenectomy Portal veins Mesenteric vein
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