CAJ | 학술논문

目的　探讨胰腺癌、壶腹周围癌与门静脉(PV)系统的关系，制定正确的手术方案，提高手术切除率。方法　对我院1988～2000年所收治的17例胰腺癌和壶腹周围癌患者的临床资料进行回顾性分析。结果　术前采用彩色多普勒超声(CDUS)和CT检查诊断PV系统未受肿瘤侵犯12例，受肿瘤侵犯5例。14例术前CDUS和CT检查结果与手术探查结果相符，准确率82.4%，本组中9例能手术切除，2例做了PV壁部分切除和整形缝合术。结论　胰腺癌、壶腹部周围癌术前通过CDUS和CT检查，明确肿瘤与PV系统的关系，肿瘤未侵犯PV系统和PV系统有微小肿瘤侵犯，血管内膜未受侵犯或血管能与胰腺分离者，可手术切除。血管被肿瘤包埋，明显的血管狭窄或闭塞，肿瘤累及肠系膜上动脉(SMA)或腹腔干近侧，肿瘤侵犯PV系统血管内膜或血管内肿块，均列为手术禁忌。
목적　탐토이선암、호복주위암여문정맥(PV)계통적관계，제정정학적수술방안，제고수술절제솔。방법　대아원1988～2000년소수치적17례이선암화호복주위암환자적림상자료진행회고성분석。결과　술전채용채색다보륵초성(CDUS)화CT검사진단PV계통미수종류침범12례，수종류침범5례。14례술전CDUS화CT검사결과여수술탐사결과상부，준학솔82.4%，본조중9례능수술절제，2례주료PV벽부분절제화정형봉합술。결론　이선암、호복부주위암술전통과CDUS화CT검사，명학종류여PV계통적관계，종류미침범PV계통화PV계통유미소종류침범，혈관내막미수침범혹혈관능여이선분리자，가수술절제。혈관피종류포매，명현적혈관협착혹폐새，종류루급장계막상동맥(SMA)혹복강간근측，종류침범PV계통혈관내막혹혈관내종괴，균렬위수술금기。
Objective　To study the relation between the pancreatic and peri-ampullar carcinomas and portal vein (PV) to make a relevant surgical procedure and to enhance the resecable rate of pancreatic and peri-ampullar carcinomas.Methods　A retrospective analysis of 17 cases of pancreatic and peri-ampullar carcinomas was made.Results　It was found preoperatively that the PV of 12 cases was not invaded by tumors through the examination of CDUS and CT and 5 was invaded.The results of CDUS and CT examinations were the same as those of the operation exploration with the accuracy of diagnosis being 82.4%.In this group,9 cases underwent operation resection and 2 part resection of PV wall and plastic operation.Conclusion　Preoperative examination of CDUS and CT to the patients with pancreatic or peri-ampullar carcinoma could understand the relation between the tumors and PC.For those with PV invasion or PV invasion by a little tumor,but without invasion of vascular tunica intima,the pancreatic carcinoma could be removed.The contraindications of the operation forpancreatic or peri-ampullar carcinoma were as follows:surrounding of vessels by tumors,obvious narrow or embolization of the vessels,invasion of the superior mesenteric arteries and celiac trunk,invasion of vascular tunica intima of PV,or tumors in vascular cavity.