Whipple术根治胆管下段癌远期疗效及影响因素

目的 探讨胆管下段癌(DCC)术后远期疗效及影响因素.方法 选取1998年11月至2010年11月间87 例实施胰十二指肠切除术(Whipple术)的DCC患者.结果 患者1、3、5年生存率分别为65.36%、51.47%和22.84%.影响DCC术后远期疗效的主要因素有病程长短、瘤体大小、病理分型、分化程度及分期、局部浸润和淋巴结转移情况等;远期疗效与患者年龄、性别、术前黄疸程度以及术后放化疗等无相关性.结论 对DCC的肿瘤分期、分型、浸润、淋巴结转移等对远期生存率的影响进行分析,强调DCC的早期诊断及根治性切除的重要性,尽可能提高患者的远期生存率.

Long-term curative effect and the influencing factor of lower bile duct cancer in patients undergone Whipple operation

Objective To probe the post-operative long-term curative effect and the influencing factor of the lower segment of bile duct cancer（DCC）.Methods Eighty-seven patients with carcinoma of the lower bile duct undergone pancreaticoduodenectomy（Whipple operation） were selected from November 1998 to November 2010.Results The 1,3,and 5-year survival rates of these patients were 65.36%,51.47% and 22.84% respectively.The main factors influencing the long-term curative effect of DCC were duration of disease,tumor size,pathological type,differentiation,staging,local invasion,lymph node metastasis,and so on.The long-term curative effect didn＇t related to age,sex,preoperative jaundice,postoperative radiotherapy,chemotherapy and other non-related factors.Conclusion Behavior of the DCC analysis of molecular biology emphasizes early diagnosis of DCC and the importance of radical resection,focuses on adjuvant therapy.Maximize long-term survival of patients should be raised if possible.