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目的提高原发性十二指肠癌的早期诊断及治疗水平。方法回顾性分析1990～2002年间经手术及病理证实的原发性十二指肠癌患者101例的临床资料。结果肿瘤位于十二指肠乳头上区9例,乳头下区15例,乳头区77例。主要临床表现为上腹隐痛、上消化道梗阻和出血及黄疸症状。术前纤维十二指肠镜确诊率为97.7%,低张十二指肠造影为91.2%,B超及CT检查阳性率为80.0%。59例行胰十二指肠切除术,24例行十二指肠乳头癌局部切除术,5例行十二指肠部分切除术,4例行远端胃大部切除术,9例行姑息性探查及胆肠或胃肠吻合术。结论纤维十二指肠镜、低张十二指肠造影及CT是诊断十二指肠癌的主要手段,早期诊断有赖于提高对本病的认识,一旦确诊则手术彻底切除肿瘤是首选的治疗方法。
Objective To improve the early diagnosis and treatment of primary duodenal cancer. Methods The clinical data of 101 patients with primary duodenal cancer confirmed by operation and pathology from 1990 to 2002 were retrospectively analyzed. Results The tumors were found in 9 cases of duodenal papilla, 15 cases of papillary region and 77 cases of papillary region. The main clinical manifestations of upper abdominal pain, upper gastrointestinal obstruction and bleeding and jaundice symptoms. Preoperative diagnosis of fiber duodenoscopy was 97.7%, low duodenal radiography 91.2%, B ultrasound and CT examination positive rate was 80.0%. Fifty-nine patients underwent pancreatoduodenectomy, 24 underwent local excision of duodenal papillary carcinoma, 5 underwent partial duodenal resection, 4 underwent distal gastrectomy, and 9 underwent palliative treatment Sexual exploration and gallbladder or gastrointestinal anastomosis. Conclusions Fibrous duodenoscopy, low-resolution duodenoscopy and CT are the main methods to diagnose duodenal cancer. Early diagnosis depends on improving the understanding of the disease. Once the diagnosis is complete, complete removal of the tumor is the preferred treatment method.