天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (7): 728-732.doi: 10.11958/20180332

• 诊断技术 • 上一篇    下一篇

可能切除性胰腺体尾部癌的外科手术治疗研究

李鸿侠 1，尚海涛 2，张西波 2，鲍建亨 2，郝成飞 2，刘军舰 2，李忠廉 2△   

  1. 1天津医科大学研究生院（邮编300070）；2天津市南开医院肝胆胰第二外科
  • 收稿日期:2018-03-06 修回日期:2018-04-23 出版日期:2018-07-15 发布日期:2018-07-15
  • 通讯作者: 李忠廉 E-mail:nkyylzl@163.com
  • 作者简介:李鸿侠（1990），女，硕士在读，主要从事肝胆胰外科的基础与临床研究
  • 基金资助:
    基于内质网应激的清热利湿法防治阻塞性黄疸肝损伤的分子机制研究

Clinical research of operation in the treatment for potentially resectable cancer of pancreatic body-tail

LI Hong-xia1, SHANG Hai-tao2, ZHANG Xi-bo2, BAO Jian-heng2, HAO Cheng-fei2, LIU Jun-jian2, LI Zhong-lian2△   

  1. 1 Graduate School of Tianjin Medical University, Tianjin 300070, China; 2 Department of the Second Hepatobiliary and Pancreatic Surgery, Tianjin Nankai Hospital △Corresponding Author E-mail: nkyylzl@163.com
  • Received:2018-03-06 Revised:2018-04-23 Published:2018-07-15 Online:2018-07-15

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摘要： 目的 探讨可能切除性胰腺体尾部癌行外科手术治疗的技术方法及临床疗效。方法 11例伴有局部侵 犯的可能切除性胰腺体尾部癌患者，均以逆行切除方式施行根治性切除手术，同时辅以术后化疗并追踪随访。结 果 11例患者中10例达到R0切除，1例为R1切除。3例切除了受累的腹腔干血管（CA）及肝总动脉（CHA），其中2 例联合了全胃切除、空肠代胃术，1例因切口感染延长了住院时间外，其余病例均无严重并发症发生。术后除2例患 者未能坚持规律化疗外，其余患者均行吉西他滨规律化疗。术后全部患者腹痛症状消失，中位生存时间28（14，36） 个月，术后1年、3年生存率分别为90.9%、36.3%。结论 可能切除性胰腺体尾部癌患者手术切除率低并长期被腹痛 困扰，以逆行切除手术方式，必要时扩大手术切除范围的方法并辅助术后化疗可以一定程度延长患者的生存时间并 显著改善患者的生活质量。

关键词: 胰腺肿瘤, 外科手术, 可能切除性, 胰腺体尾部癌, 根治性切除

Abstract: Objective To discuss the clinical effect and technical method of the surgical treatment for potentially resectable cancer of pancreatic body-tail. Methods Eleven patients with potentially resectable cancer of pancreatic body-tail or adjacent organ metastasis, who underwent wide excision and postoperative chemotherapy in our department were retrospectively analyzed. Results In eleven patients, 10 patients with adjacent organ metastasis were performed involved organs resection, 3 patients were given resection of the celiac axis (CA) and common hepatic artery (CHA) and 2 patients were given total gastrectomy and jejunal interposition pouch reconstruction. One patient had prolonged hospital stay due to incision infection, but no serious complications occurred in other patients. Except for 2 patients, the other patients underwent postoperative chemotherapy of gemcitabine. All of the patients achieved relief through operation. The median survival time was 28 (14, 36) months. One and 3-year survival rates were 90.9% and 36.3%. Conclusion The resection rate of potentially resectable carcinoma of pancreatic body and tail operation is lower, and patients have long been plagued by abdominal pain. The treatment of extensive resection operation and recessive resection and postoperative adjuvant chemotherapy can improve the quality of life and prolong the survival rate of patients

Key words: pancreatic neoplasms, surgical procedures, operative, potentially resectable, pancreatic body-tail carcinoma, radical resection