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背景与目的:胰头癌、十二指肠癌的治疗,手术切除仍是唯一可能根治的有效方法。但临床确诊时,多数为晚期,常累及门静脉/肠系膜上静脉、下腔静脉即属手术禁忌症。本研究旨在探讨累及门静脉/肠系膜上静脉、下腔静脉的胰头癌、十二指肠癌切除的处理方法,以提高切除率及生存率。方法:总结2002年2月—2005年6月5例联合血管重建胰十二指肠切除术的临床资料及经验,其中胰头癌合并门静脉/肠系膜上静脉切除人工血管重建3例,十二指肠癌合并下腔静脉切除人工血管重建2例。结果:本组病例无围手术期死亡。无人工血管感染、阻塞并发症。随访10个月死亡1例,24个月死亡1例,术后存活超过3年2例,超过4年1例。结论:对累及门静脉/肠系膜上静脉、下腔静脉的胰头癌、十二指肠癌行胰十二指肠切除联合血管重建手术是安全的,可提高肿瘤切除率,延长患者生存时间。
BACKGROUND & OBJECTIVE: The treatment of pancreatic head and duodenal cancer is still the only effective method for radical surgery. However, the clinical diagnosis, the majority of late, often involving the portal vein / superior mesenteric vein, inferior vena cava is a surgical contraindication. The purpose of this study was to investigate the treatment of pancreatic cancer and duodenal cancer involving the portal vein / superior mesenteric vein and inferior vena cava in order to improve the resection rate and survival rate. Methods: From February 2002 to June 2005, 5 cases of combined revascularization pancreatoduodenectomy clinical data and experience, including pancreatic cancer with portal vein / superior mesenteric vein graft reconstruction in 3 cases, 12 fingers Two cases of colorectal cancer combined with inferior vena cava resection of artificial vascular reconstruction. Results: There was no perioperative death in this group of patients. No artificial vascular infection, obstruction of complications. One patient was followed up for 10 months, 1 patient died after 24 months, 2 patients survived more than 3 years and 1 patient more than 4 years. Conclusion: Pancreaticoduodenectomy and pancreaticoduodenectomy combined with revascularization for portal and superior mesenteric vein and inferior vena cava are safe, which can improve tumor resection rate and prolong the survival time of patients.