局部切除治疗壶腹癌的临床分析

发布时间：2018-10-21 19:21

【摘要】：目的评价局部切除治疗壶腹癌的临床疗效,探讨局部切除治疗壶腹癌的可行性与合理性。方法回顾性分析2002年1月至2013年12月在我院肝胆外科行局部切除的15例壶腹癌患者的临床及病理资料。结果本组15例患者中,男性4例(26.7%),女性11例(73.3%),年龄36-76岁,平均55.5岁。因无痛性黄疸就诊的患者7例,占46.7%。因腹痛合并黄疸就诊的患者3例,占20.0%,因单纯腹痛就诊的患者3例,占20.0%,因食欲不振就诊的1例,占6.7%。15例患者均行壶腹癌局部切除术,肿瘤直径为1.8±1.45cm。术后病理结果:高分化腺癌6例(33.3%),中分化腺癌2例(13.3%),中低分化腺癌3例(20.0%),管状-绒毛腺癌1例(6.7%),神经内分泌癌1例(6.7%),不典型增生2例(13.3%)。手术时间为133±35.9min,术中出血量为161±96.9ml,无病例术中输血。住院天数22.4±8.6天。1例患者出现术后幽门梗阻,1例患者出现切口感染,1例患者出现肺部感染。其余患者均未出现胆漏、胰漏、胆道感染、出血、肝功能衰竭等并发症。本组15例患者中,12例获得随访,无手术死亡,1年、3年、5年生存率分别为83.3%,75.0%,58.3%。结论局部切除术可以作为治疗壶腹癌的一种重要术式,其具有手术创伤小、恢复快、手术死亡率及并发症发生率低的优点,其治疗的关键在于严格、准确的把握手术适应症,熟练的掌握手术技巧。
[Abstract]:Objective to evaluate the clinical efficacy of local resection in the treatment of ampullary carcinoma and to explore the feasibility and rationality of local resection in the treatment of ampullary carcinoma. Methods the clinical and pathological data of 15 patients with ampullary carcinoma underwent local resection in our hospital from January 2002 to December 2013 were retrospectively analyzed. Results among the 15 patients, 4 (26.7%) were male and 11 (73.3%) were female. The average age was 55.5 years (36-76 years). There were 7 patients with painless jaundice, accounting for 46.7%. There were 3 patients with abdominal pain complicated with jaundice (20.0%), 3 cases with simple abdominal pain (20.0%), 1 case with anorexia (6.7cm), 15 cases with ampullary carcinoma (1.8 卤1.45 cm in diameter). The pathological results were as follows: highly differentiated adenocarcinoma in 6 cases (33.3%), moderately differentiated adenocarcinoma in 2 cases (13.3%), poorly differentiated adenocarcinoma in 3 cases (20.0%), tubular choriocarcinoma in 1 case (6.7%), neuroendocrine carcinoma in 1 case (6.7%), atypical hyperplasia in 2 cases (13.3%). The operative time was 133 卤35.9min and the intraoperative blood loss was 161 卤96.9ml. The days of hospitalization were 22.4 卤8.6 days. One patient had postoperative pyloric obstruction, one patient had incisional infection, and one patient had pulmonary infection. No biliary leakage, pancreatic leakage, biliary tract infection, hemorrhage, liver failure were found in other patients. Among the 15 cases, 12 cases were followed up, and no operative death was found. The 1 year, 3 year and 5 year survival rates were 83.3%, 75.0% and 58.3%, respectively. Conclusion Local resection can be used as an important operative method for the treatment of ampullary carcinoma. It has the advantages of small trauma, quick recovery, low mortality and low incidence of complications. The key to the treatment is to strictly and accurately grasp the indication of operation. Master surgical skills skillfully.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.0

【相似文献】