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目的 探讨无黄疸期胆道扩张病人在壶腹周围癌的早期诊断 ,治疗方面的意义。方法 回顾总结 1986年 10月至 1999年 4月通过B超、CT、PTC等检出的 16例无黄疸胆道梗阻性扩张的壶腹周围癌病人切除率及生存率。结果 16例病人手术切除率 87.5 0 % ( 14 / 16) ,5年生存率 43.75 % ( 7/ 16) ,3年生存率 62 .5 0 % ( 10 / 16)。结论 壶腹周围癌病人胆道系统扩张在黄胆出现之前 ,上腹部饱胀不适、隐痛、胀痛、食欲不振等症状在黄疸前 1～ 3个月即可出现。对于出现上述症状 ,年龄超过 40岁 ,B超、CT、PTC、ERCP发现胆道扩张的病人应高度怀疑壶腹周围癌的可能 ,应及早手术探查 ,可明显提高切除率及生存率。
Objective To explore the early diagnosis and treatment of periampullary cancer in patients without jaundice during biliary dilatation. Methods Review and summarize the resection rate and survival rate of 16 cases of periampullary peri-ampullary cancer without jaundice obstructive dilatation detected by B-ultrasonography, CT, PTC, etc. from October 1986 to April 1999. Results The resection rate was 87.50% (14/16), the 5-year survival rate was 43.75% (7/16), and the 3-year survival rate was 62.50% (10/16). Conclusion Biliary dilatation in patients with periampullary cancer before the appearance of jaundice, abdominal discomfort, pain, pain, loss of appetite and other symptoms can appear 1 to 3 months before jaundice. For the above symptoms, patients over 40 years of age, B-ultrasonography, CT, PTC, ERCP found that biliary dilation of patients should be highly suspected the possibility of cancer around the ampulla, surgical exploration should be as soon as possible, can significantly increase the resection rate and survival rate.