胰腺体尾部癌的外科治疗

目的探讨胰腺体尾部癌患者的外科治疗及预后。方法回顾性研究1996年1月至2006年6月我院外科治疗的87例胰体尾癌患者的临床资料,分析R0切除、姑息性切除、短路手术和未手术治疗对患者近期和远期疗效的影响。结果本组手术探查59例,肿瘤切除27例,其中R0切除21例,姑息切除6例。R0切除组中联合脏器或血管切除9例。短路手术13例,仅行开腹探查、活检19例。各组围手术期死亡率无差异,联合脏器切除组合并症发生率高于其他各组。87例胰体尾癌患者总中位生存期为7.9个月。R0切除组、姑息性切除组、短路手术组与未切除组中位生存期分别为17.2个月、7.3个月、4.7个月和5.2个月。肿瘤切除组患者疼痛缓解率高于姑息手术组及短路手术组（P=0.03）。结论对胰体尾癌患者应提倡积极手术治疗,即使姑息切除,亦可缓解疼痛症状。

Surgical therapy for carcinoma of the body and tail of the pancreas

Objective To evaluate surgical therapy and prognosis of patients with carcinoma of the body and tail of the pancreas. Method Clinical data of 87 patients of body and tail adenocarcinoma of the pancreas in our hospital from Jan 1996 to June 2006 were retrospectively analyzed. Result Laparotomy was performed in 59 patients. Resective operation was performed in 27 patients, including R0 resection in 21 patients, palliative operation in 6 patients. Among the 21 R0 cases, 6 patients underwent multiple organ resection. The shunt operation was performed in 13 cases. Laparotomy and biopsy only was performed in 19 cases. There was no significant difference of perioperation mortality among all operative subgroups. The complication rate of patients in combined multiple organs resection group was higher than that of other groups. In this study the median survival of 87 patients was 7.9 months and it was 17. 2 months for R0 resection, 7. 3 months for palliative operation, 4. 7months for shunt operation and 5.2 months for observative treatment, respectively. Pain relief rate was higher in resection group than that in the other groups. Conclusion Surgical treatment should be encouraged for patients with adenocarcinoma of the body and tail of the pancreas, because even palliative resection relieves pains.