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

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(P0.01),两组的住院时间比较无明显差异(P0.05);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(P0.05),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。

Short and Long Term Efficacy and Safety of Pancreaticoduodenectomy for Pancreatic Head Carcinoma and Periampullary Carcinoma

ABSTRACT Objective: To investigate the recent and long-term efficacy and safety of pancreaticoduodenectomy for pancreatic head carcinoma and periampullary carcinoma. Methods: 82 cases of pancreatic cancer combined with periampullary carcinoma patients admit- ted in our hospital from August 2009 to June 2013 were selected and randomly divided into the control group and the observation group With 41 patients in each group. The control group received palliative surgical treatment, while the observation group underwent pancre- atoduodenectomy. The operation time, hospitalization time, intraoperative bleeding volume and the incidence of complications, 1, 2, 3-year survival rate and the recurrence rate at 1 year after operation and tumor eradication rate were compared between twp groups. Results: The amount of bleeding, operation time of observation group were significantly higher than those of the control group(P<0.01), no signif- icant difference was found in the hospitalization time between the two groups(P>0.05); the incidence of complications in the observation group (41.46%) was significantly higher than the control group(22.96%)(P=0.03); the 2-year and 3-year survival rate of observation group were significantly higher than those of the control group (P<0.05), the recurrence rate at 1 year after operation of observation group was significantly lower than that of the control group (P=0.04), the tumor eradication rate was significantly higher in the observation group than that of the control group(P=0.04). Conclusion: Though pancreaticoduodenectomy could prolong the operation time, increase the risk of bleeding and complications for pancreatic head carcinoma and periampullary carcinoma, but it could effectively reduce the possibility of recurrence after operation, significantly improve the long-term survival rate.