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目的 探讨Vater壶腹部肿瘤行壶腹部扩大切除的根治性手术的方法,以减少非肿瘤器官切除,并符合肿瘤治疗原则。方法 总结1995-1998年手术切除的根治术的经验。经十二指肠后外侧入路,整块切除肝外胆道、胆胰管汇合部,壶腹部及十二指肠乳头,十二指肠乳头封闭术。胆、胰、十二指肠间置空肠或胆、胰空肠Roux-en-Y吻合术。结果 围手术期死亡1例。并发症1例经再手术治愈。随访术后半年以上病人9例,最长生存29个月,无并发症及转移征象。结论（1）该术式符合胰十二指肠解剖关系;（2）按肿瘤治疗原则能达到广泛程度清扫;（3）初行该术式者应掌握胰十二指肠切除术。
Objective To investigate the method of radical surgery for ampulla of ampulla of Vater for amputation in order to reduce non-tumor organ resection and accord with the principle of tumor treatment. Methods To summarize the experience of radical resection of the surgical resection from 1995 to 1998. After the lateral approach of the duodenum, the whole resection of the extrahepatic biliary tract, biliary and pancreatic duct confluence, ampulla and duodenal papilla, duodenal papilla closure. Gallbladder, pancreas, duodenum interspace jejunum or gallbladder, Roux-en-Y pancreatic jejunostomy. Results Perioperative death in 1 case. One case of complications was cured by re-operation. Nine patients were followed up more than six months after surgery, the longest survival of 29 months, no complications and signs of metastasis. Conclusions (1) The procedure is consistent with pancreaticoduodenal anatomical relationship; (2) according to the principle of tumor treatment can achieve a wide range of cleaning; (3) the first line of operation who should have pancreatoduodenectomy.