胰头癌42例诊疗体会

目的　探讨胰头癌的早期诊断和合理的外科治疗措施。方法　对我院 1998年 1月至2 0 0 2年 12月间 ,4 2例胰头癌病人的临床资料和诊治过程进行回顾性分析。结果　所有病例均经剖腹手术和病理检查证实为胰头癌。 92 .8%的病人出现上腹饱胀不适的时间早于黄疸 1～ 2月。胰头癌的ERCP、MRCP、CT等检查的影像学特征明显。其中 ,16例行胰十二指肠切除术 ,手术切除率为38.1%。结论　应重视胰头癌早期非特异性症状 ,合理运用各种影像学检查方法 ,以达到早期诊断的目的。对于诊断明确的病人 ,宜采用合理扩大的胰十二指肠切除术 ,以提高手术切除率 ,改进手术质量。

Early diagnosis and surgical treatment for carcinoma of the head of pancreas of 42 cases

Objective To investigate the early diagnosis and rational surgical treatment for carcinoma of the head of pancreas.Methods The clinical data and treatment processes of 42 patients suffered from carcinoma of the head of pancreas from 1998. 1 to 2002. 12 were analysed retrospectively. Carcinoma of the head of pancreas in all the cases was diagnosed by surgical operation and pathological observation. 92.8% of all the cases had upper abdomical distension 1 to 2 months prior to the appearance of jaundice. The imaging characteristics of ERCP, MRCP, CT were significant. Pancreaticoduodenectomy was performed in 16 patients and its resection rate was 38.1% .Conclusion It is important to pay great attention to the unspecific symptoms of the epigustrium. ERCP,MRCP,CT and the other imaging techniques should be conducted appropriately to discover the early patients. Extended pancreaticoduodenectomy should be performed rationally in the patients with the definite diagnosis to increase the resection rate and improve the operative quality.