CAJ | 학술논문

目的探讨进展期胰头癌并门静脉及肝转移扩大根治切除与改良术式,以提高切除率、生存率及生活质量.方法以美国癌肿联合委员会(ALCC)TNM分期标准入选的胰腺癌住院患者为受术对象,选择胰头癌剖腹探查60例,其中27例扩大根治合并门静脉转移部分切除19例,肝左叶及肝右叶肝段切除8例,采用改良Whipple术式间置空肠Y形重建消化道和门静脉血管重建;27例术后分介入灌注化疗治疗组13例和对照组14例.结果 27例术后均无严重并发症及手术死亡,治疗组和对照组2、3、5年生存率分别为61.5%、38.4%、23.O%和42.8%、21.4%、14.3%.治疗组和对照组生存率差异有统计学意义(P均<O.05).结论扩大根治切除与改良术并术中、术后介入化疗可显提高生存率和改善生活质量.
목적 탐토진전기이두암병문정맥급간전이확대근치절제여개량술식,이제고절제솔、생존솔급생활질량.방법 이미국암종연합위원회(ALCC)TNM분기표준입선적이선암주원환자위수술대상,선택이두암부복탐사60례,기중27례확대근치합병문정맥전이부분절제19례,간좌협급간우협간단절제8례,채용개량Whipple술식간치공장Y형중건소화도화문정맥혈관중건;27례술후분개입관주화료치료조13례화대조조14례.결과 27례술후균무엄중병발증급수술사망,치료조화대조조2、3、5년생존솔분별위61.5%、38.4%、23.O%화42.8%、21.4%、14.3%.치료조화대조조생존솔차이유통계학의의(P균<O.05).결론 확대근치절제여개량술병술중、술후개입화료가현제고생존솔화개선생활질량.
Objective To retrospeetivley explore the expanded radicM resectable range and improved Surgical approach of the progressive pancreatic head cancer with metastasis of portal vein(PV) and liver,and try to improve the resectable rate.survival rate and quality of life.Methods The patients witll late pancreatic cancer sis of partial PV resection and 8 cases of left leaf or right leaf sectional hepatectomy partial were involved in 27 cases,reconstructed gastrointestinal tract with improved Whipple interposed Y-type jejunostomy and PV.27 cases were randomly divided into intervention chemotherapy of treatment groups(n=13) and control groups(n=14).Results Severe complications or dead cases were not found in 27 cases after operation.The 2-,3-,5-years survival rates were 61.5%,38.4%,23.0%,and 42.8%,21.4%,14.3% in treatment group and control group,respectively.The survival rate was statistically different(P<0.05).Conclusions The expanded radical pancreatoduodenectomy and its improved surgical approach can improve not only the survival rate but also the quality of life.