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我院最近21年间,手术治疗胰头癌和壶腹周围癌共351例(胰头癌211例,壶腹周围癌140例)。手术包括胰～十二指肠切除72例(20.5%),内引流术183例(52.2%),剖腹探查活检96例(27.3%)。在72例胰～十二指肠切除手术中有1例手术死亡,手术死亡率为1.3%,用我们改良的胰～十二指肠切除术式,术后并发症和死亡率明显下降。壶腹周围癌的切除率(40%)比胰头癌(7%)高,且切除后平均生存时间也比胰头癌长;故对壶腹周围癌应首选胰～十二指肠切除术,对不能切除的胰头+应作内引流术。
In the last 21 years of our hospital, there have been 351 cases of pancreatic head cancer and periampullary cancer surgery (211 cases of pancreatic cancer and 140 cases of periampullary cancer). Surgery included pancreato-duodenectomy in 72 (20.5%), internal drainage in 183 (52.2%), and laparotomy in 96 (27.3%). In 72 cases of pancreaticoduodenectomy, there was 1 case of surgical death. The operative mortality was 1.3%. With our modified pancreato-duodenectomy, postoperative complications and mortality were significantly reduced. The periampullary cancer resection rate (40%) was higher than that of pancreatic head cancer (7%), and the average survival time after resection was longer than that of pancreatic head cancer; therefore pancreato-duodenectomy should be the first choice for periampullary cancer. For the unresectable pancreatic head + internal drainage should be performed.