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目的分析研究胰头癌阻塞性黄疸手术的术式选择。方法回顾性分析2009年3月至2011年3月期间在本院治疗的60例胰头癌阻塞性黄疸患者的临床资料。将60例患者随机分为单纯胆囊空肠吻合术组,肝(胆)总管空肠吻合术组和胆肠吻合加胃空肠吻合术组,每组20例,比较3组患者临床死亡率、生存期及术后复发率。结果单纯胆囊空肠吻合术组死亡4例,死亡率为20%,术后黄疽或胆管炎复发率为62.5%,生存期为7.4个月;肝(胆)总管空肠吻合术组死亡3例,死亡率为15%,黄疽和胆管炎复发率为17.65%,生存期11.3个月;胆肠吻合加胃空肠吻合术组30内死亡1例,死亡率为5%,术后黄疽或胆管炎发生率为5.26%,平均生存期为16.5个月。结论胆肠吻合加胃空肠吻合术安全可靠,易于掌握,且临床疗效较好,有临床应用价值。
Objective To analyze the operative choice of obstructive jaundice for pancreatic cancer. Methods The clinical data of 60 patients with obstructive jaundice of pancreatic cancer who were treated in our hospital from March 2009 to March 2011 were analyzed retrospectively. Sixty patients were randomly divided into simple gallbladder jejunostomy group, common bile duct jejunostomy group and cholecystojejunostomy combined with gastrojejunostomy group, with 20 cases in each group. The clinical mortality, survival time, Postoperative recurrence rate. Results In the gallbladder jejunostomy group, 4 patients died and the mortality rate was 20%. The recurrence rate of jaundice or cholangitis was 62.5% and the survival time was 7.4 months. In the jejunum anastomosis group, 3 patients died, The mortality was 15%. The recurrence rate of jaundice and cholangitis was 17.65% and the survival time was 11.3 months. In the jejunostomy and jejunostomy group, there were 1 death in 30 cases, the mortality rate was 5%, and jaundice or bile duct The incidence of inflammation was 5.26% and the average survival time was 16.5 months. Conclusions The choledochojejunostomy combined with gastrojejunostomy is safe and easy to master, and has good clinical curative effect and clinical value.