架桥式内引流治疗晚期壶腹周围癌

目的　探讨手术解除晚期壶腹周围癌致阻塞性黄疸的可行方法。方法　在 11例手术不能切除的晚期壶腹周围癌病人的胆总管置入 18号T型管 ,T型管的另一端插入十二指肠约 10cm ,包埋、固定。使T型管在胆总管与十二指肠之间 ,形成一个“架桥式”结构。然后行胃空肠吻合和空肠与空肠的侧侧吻合 ,并与单纯剖腹探查组病人比较。结果　该组病人术后 6个月生存率为 72 .7%(8/ 11) ,9个月生存率为 4 5 .5 % (5 / 11) ,12个月生存率为 9% (1/ 11) ;单纯剖腹探查组病人术后 6个月生存率为 11.1% (1/ 9) ,9个月生存率为 0。结论　该手术方法简单、安全 ,可用于多种原因造成恶性阻塞性黄疸的病人 ,且费用低廉适合于我国国情 ,值得进一步推广。

Building a Bridge with "T" tube to treat the later Cancers Around Ampullae

Objective To study a feasible ways to surgically relief the obstructive jaundice induced by later cancers around ampullae.Methods During operations,T type tubes were into the common bile ducts in 11 patients with unresectable later cancers around ampullae to build a bridge and perform gastroenterostomy. The outcome of these patients was compared with that in other patients subject to pure laparotomy. Among the 11 patients, the 6 month survival rate was 72.7 % (8/11), the 9 month survivval rate was 45.5 % (5/11), and the 12 month survival rate was 9 % (1/11) respectively. But in the control group, the 6 month survival rate was 11.1 % (1/9) and the 9 month survival was zero respectively.Conclusion The operation about bridging was simple and safe. The operation could be available to treat the patients with vicious obstructive jaundice.