CAJ | 학술논문

目的探讨老年患者胰腺癌接受胰十二指肠切除术,以期明确手术成功的相关因素.方法本研究包括74例大胰癌患者.35例年龄大于70岁, 30例为标准胰十二指肠切除术和5例为区域性胰十二指肠切除术,其中15例按"三步法"予以切除.这组患者的结果与另外39例非老年患者作比较.结果老年患者的30天手术死亡率与并发症率分别为5.9%和26.4%;而在非老年患者中分别为5.2%和18.4%.危险因素、并发症率和死亡率差别有统计学意义.老年患者和非老年患者的5年生存率分别为11.7%和15.7%,无显著性差异.结论本研究表明老年患者可安全接受根治性胰十二指肠切除术,而长期效果与非老年患者相似.减黄可改善肝、肾功能,增加患者对手术的耐受.术前介入化疗可在肿瘤与门静脉间产生"炎性水帘",从而减少门静脉切除率.
목적탐토노년환자이선암접수이십이지장절제술,이기명학수술성공적상관인소.방법본연구포괄74례대이암환자.35례년령대우70세, 30례위표준이십이지장절제술화5례위구역성이십이지장절제술,기중15례안"삼보법"여이절제.저조환자적결과여령외39례비노년환자작비교.결과노년환자적30천수술사망솔여병발증솔분별위5.9%화26.4%;이재비노년환자중분별위5.2%화18.4%.위험인소、병발증솔화사망솔차별유통계학의의.노년환자화비노년환자적5년생존솔분별위11.7%화15.7%,무현저성차이.결론본연구표명노년환자가안전접수근치성이십이지장절제술,이장기효과여비노년환자상사.감황가개선간、신공능,증가환자대수술적내수.술전개입화료가재종류여문정맥간산생"염성수렴",종이감소문정맥절제솔.
Objective To elucidate contributing factors that lead to successful management of large pancreatic cancer in geriatric patients.Methods The study involved 74 patients with larger pancreatic malignancy. Risks and benefits of pancreaticoduodenectomy at an advanced age were analyzed retrospectively in 35 patients older than 70 years of age. Of them, 15 elderly patients were radically resected by "3 steps procedure". Conventional and regional pancreaticoduodenectomy was performed in 30 and 5 patients, respectively. The results achieved in these patients were compared with those observed in 39 younger patients. Results The 30-day mortality and morbidity rates for the elderly patients with large pancreatic cancer were 5.9% and 26.4% respectively; while for the younger patients, they were 5.2% and 18.4% respectively. A statistically significant correlation was observed between the presence of risk factors, the occurrence of complications, and the mortality rate. No difference was found between the two age groups when the risk factors were absent. The 5-year survival rate in the elderly patients and the younger patients was 11.7% and 15.7% respectively, with the difference being not significant. Conclusion Curative pancreaticoduodenectomy can be carried out safely in older patients, with long-term results comparable to those achieved in the younger patients. The preoperative interventional chemotherapy can provide an inflammatory edema wall between the tumor and portal vein, so as to decrease the portal vein resection rates.