壶腹周围癌45例诊治的临床分析

目的：探讨壶腹周围癌的诊断和治疗方法。方法：回顾分析2000年1月—2011年1月收治的45例壶腹周围癌患者的临床资料。结果：45例壶腹周围癌患者以梗阻性黄疸和上腹部不适、疼痛为主要临床表现;影像学检查主要表现为胰头部、壶腹部肿物及胆、胰管扩张;经内镜逆行胆胰管造影术（ERCP）显示直接、间接征象和特征性改变。行胰十二指肠切除术29例,十二指肠肿瘤局部切除术3例,行胆囊空肠吻合术4例,胆总管空肠吻合术4例,胆总管十二指肠吻合术1例,胃空肠吻合术4例。结论：腹部非特异性症状结合影像学检查可提高壶腹周围癌的早期诊断率。胰十二指肠切除术是治疗壶腹周围癌最有效的方法。

Diagnosis and Treatment of 45 Cases with Periampullar Carcinoma

Objective:To summarize the clinical experience of diagnosis and treatment for periampullar carcinoma.Methods:Clinical data of 45 patients with carcinoma of periampullar in our hospital during the last 11 years were reviewed retrospectively.Results:The main clinical symptoms of the 45 cases were obstructive jaundice,epigastric discomfort and pain.The main imagic characteristics were pancreatic-head and ampullary masses,dilations of biliary and pancreatic duct.Endoscopic retrograde cholangio pancreatogrophy(E...