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目的:研究胰十二指肠切除术治疗胰头癌伴壶腹周围癌的近远期疗效及安全性。方法:研究对象选取我院2009年8月到2013年6月间收治的胰头癌伴壶腹周围癌患者82例,采用随机数字法将其分为对照组和观察组,每组各41例。对照组患者接受姑息性手术治疗,观察组患者接受胰十二指肠切除术治疗,比较两组患者的手术时间、住院时间、术中出血量及并发症发生率,术后随访3年,比较两组患者术后1年、2年及3年生存率、术后1年复发率以及肿瘤根除率。结果:观察组的手术时间和术中出血量均明显高于对照组(P<0.01),两组的住院时间比较无明显差异(P>0.05);观察组的总并发症发生率(41.46%)明显高于对照组(22.96%)(P=0.03),术后2年和3年的生存率明显高于对照组(P<0.05),术后1年的复发率明显低于对照组(P=0.04),肿瘤根除率明显高于对照组(P=0.04)。结论:胰十二指肠切除术治疗胰头癌伴壶腹周围癌虽可延长手术时间,提高术中出血量及并发症风险,但肿瘤根治效果更好,可减少术后复发,明显提高远期生存率。
Objective: To study the short-term and long-term efficacy and safety of pancreatoduodenectomy in the treatment of pancreatic head cancer with ampullary carcinoma. Methods: Selected 82 cases of pancreatic cancer with ampullary carcinoma who were treated in our hospital from August 2009 to June 2013. The patients were divided into control group and observation group by random number method, with 41 cases in each group . Patients in the control group received palliative surgery. Patients in the observation group received pancreaticoduodenectomy. The operation time, hospitalization time, intraoperative blood loss and complication rates were compared between the two groups. The patients were followed up for 3 years One-year, two-year and three-year survival rates, one year postoperative recurrence rate and tumor eradication rate were compared between the two groups. Results: The operation time and intraoperative blood loss in the observation group were significantly higher than those in the control group (P <0.01). There was no significant difference in hospitalization time between the two groups (P> 0.05). The total complication rate in the observation group was 41.46% ) Was significantly higher than that of the control group (22.96%) (P = 0.03). The survival rates at 2 years and 3 years after operation were significantly higher than those in the control group (P <0.05). The recurrence rate at 1 year after operation was significantly lower than that in the control group P = 0.04), the tumor eradication rate was significantly higher than the control group (P = 0.04). Conclusion: Pancreaticoduodenectomy for the treatment of pancreatic cancer with ampullary carcinoma may prolong the operation time and increase the intraoperative bleeding and the risk of complications. However, the curative effect of the tumor is better, which can reduce the postoperative recurrence and improve significantly Survival rate.