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目的 探讨胰腺癌的早期诊断与外科处理.方法 回顾分析24例胰腺癌诊断和治疗情况.结果 24例胰腺癌中,胰头癌19例,胰体尾癌5例;经B超、CT诊断24例,MRI 18例,MRCP8例,RECP 12例,DSA 3例,IOUS 11例,FNAB 17例;根治性切除4例,胆囊空肠内引流术 13例,附加胃空肠吻合术6例,胆囊空肠双造口4例,瘤体内注射无水乙醇6例,胃十二指肠动脉区域化疗8例,PTCD 3例.术后胰瘘1例,疼痛缓解 18例,黄疸减退/消失 14例,死亡 1例,其余术后恢复良好.结论 可疑胰腺癌患者,联合运用影像学、肿瘤标记物、穿刺检查等方法,才能提高早期诊断率.恰当的外科处理,术后辅助性区域放、化疗和免疫调节治疗,是提高胰腺癌患者生存期、降低术后并发症和病死率的必要措施.
Objective To investigate the early diagnosis and surgical treatment of pancreatic cancer.Methods The diagnosis and treatment of 24 cases of pancreatic cancer were retrospectively analyzed.Results Of the 24 cases of pancreatic cancer, there were 19 cases of pancreatic head cancer and 5 cases of pancreatic body and tail cancer, 18 cases of MRI, 8 cases of MRCP, 12 cases of RECP, 3 cases of DSA, 11 cases of IOUS, 17 cases of FNAB; radical curative resection in 4 cases, cholecystojejunal drainage in 13 cases, additional gastrojejunostomy in 6 cases, gallbladder jejunum double 4 cases of ostomy, 6 cases of ethanol in the tumor, 8 cases of gastroduodenal artery chemotherapy, 3 cases of PTCD, 1 case of postoperative pancreatic fistula, 18 cases of pain relief, 14 cases of jaundice subsided / disappeared, 1 died Cases, the rest of the postoperative recovery is good.Conclusion In patients with suspected pancreatic cancer, the combined use of imaging, tumor markers, puncture and other methods to improve the early diagnosis rate.Appropriate surgical treatment, postoperative adjuvant regional radiotherapy, chemotherapy and immune regulation Treatment is to improve the survival of patients with pancreatic cancer, reduce postoperative complications and mortality necessary measures.