胰头及壶腹周围癌广泛淋巴结清扫的可行性及意义

目的: 探讨胰头及壶腹周围癌广泛淋巴结清扫可行性和意义,并提出行广泛淋巴结清扫的指征。方法: 对2000年10月~2003年10月的16例胰头及壶腹周围癌进行广泛淋巴结清扫术资料进行分析。结果: 16例中有6例出现淋巴结转移,转移率为37.5%。胰头癌与壶腹周围癌、肿块大小和胰头肿瘤部位间发生淋巴结转移均无明显不同(P=0.588~P=0.511)。行广泛淋巴结清扫术病例中无手术死亡,手术并发症也是胰十二指肠切除常见并发症。结论: 胰头及壶腹周围癌肿瘤大于3 cm以上,无论是位于胰头还是壶腹部癌均应在胰十二指肠切除同时行胰头周围广泛淋巴结清扫,手术是安全的。

Extended lymph node dissection for the carinoma of the head of the pancreas and periampullary adenocarcinoma

Objective:To explore the feasibility and significance of extended lymph node dissection in treating patients with the carcinoma of the head of the pancreas and periampullary adenocarcinoma and to make out the appropriate indications for extended lymph node dissection.Methods:The clinical data of 16 cases of carcinoma of the head of the pancreas and periampullary adenocarcinoma subjected to extended lymph node dissection from October 2000 to October 2003 were analyzed.Results:Six of 16 cases were lymph node positive(37.5%) and the positive rate in cases with the tumor of the head of the pancreas and periampullary adenocarcinoma was not obviously different in the diameter,locating the head of the pancreas(P=0.588-P=0.511).The incidence of complications was not noticeably increased and there was no operative mortality.Conclusions:Extended lymph node dissection in treating patients with carcinoma of the head of the pancreas and periampullary adenocarcinoma appears to be relatively safe,feasible and effective.