无黄疸期胆道扩张在壶腹周围癌中的诊断意义（附16例报告）

目的 探讨无黄疸期胆道扩张病人在壶腹周围癌的早期诊断，治疗方面的意义。方法 回顾总结1986年10月至1999年4月通过B超、CT、PTC等检出的16例无黄疸胆道梗阻性扩张的壶腹周围癌病人切除率及生存率。结果 16例病人手术切除率87．50％（14／16），5年生存率43．75％（7／16），3年生存率62．50％（10／16）。结论 壶腹周围癌病人胆道系统扩张在黄胆出现之前，上腹部饱胀不适、隐痛、食欲不振等症 状在黄疸前1－3个月即可出现。对于出现上述症状，年龄超过40岁，B超、CT、PTC、ERCP发现胆道扩张的病人应高度怀疑壶腹周围癌的可能，应及早手术探查，可明显提高切除率及生存率。

Diagnostic significance of anicteric biliary tract dilatation in periampullary carcinoma(16 cases report)

Objective To study significance of anicteric biliary tract dilatation in early diagnosis and treatment of patients with periampullary carcinoma.Method Review the resection rate and survival rate of 16 periampullary carcinoma patients with anicteric biliary tract obstruction found out by B-ultrasound,CT or PTC during 13 years(1986-1999).Result The operative resection rate was 87.50%(14/16) ,5-year survival rate was 43.75%(7/16),3-year survival rate was 62.50%(10/16).Conclusions Biliary tract dilatation existed before icterus occurred,while syndromes such as upset of upper abdomen,reclusion, epigastralgia distention and anorexia, may occur 1-3 months ahead of icterus occurred in patients with periampullary carcinoma. If the patient has syndromes mentioned above, more than 40 years of age and biliary tract dilatation found by B-ultrasound, CT,PTC or ERCP, periampullary carcinoma should be considered. The patients should be checked by operation,so as to raise the operative resection rate and survival rate.