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目的探讨联合血管重建胰腺癌根治术的治疗效果。方法选择我院2008年3月-2011年3月胰腺癌患者共14例,本组所选患者术前均行CT、彩色多普勒超声等检查,以上患者癌症肿块直径小于5cm,门静脉、肠系膜上静脉等血管内未发现癌栓,肝脏和腹腔未发现转移。麻醉成功后,行联合血管重建胰腺癌根治术。结果病理组织学检查显示胰腺切缘无癌肿累及,分化良好乳头状腺癌患者共2例,分化中等患者共8例,粘液腺癌共2例,囊腺癌患者共2例。其中4例患者癌肿仅粘连及肠系膜上静脉-门静脉,其余患者均为癌肿累及相关血管壁,但未进入血管内。2例患者行区域性胰腺切除术后出现胃潴留,其余患者没有发生胆漏或胰漏,没有出现显著的腹胀及腹泻。本组14患者术后均随访,最长随访5年,均无胰腺癌复发,CT及彩色多普勒超市检查显示移植人造血管通畅。结论联合血管重建胰腺癌根治术疗效显著,但要注意手术适应证和严格选择合适病例。
Objective To investigate the therapeutic effect of combined revascularization in the treatment of pancreatic cancer. Methods Select our hospital from March 2008 to March 2011 a total of 14 patients with pancreatic cancer, the selected group of patients undergoing preoperative CT, color Doppler ultrasound examination, the above patients with cancer mass less than 5cm in diameter, portal vein, mesentery On the vein and other blood vessels found no tumor thrombus, liver and abdominal metastasis was not found. After successful anesthesia, combined with revascularization of pancreatic cancer radical surgery. Results Histopathological examination showed no tumor involvement in the resected margin of the pancreas. There were 2 patients with well-differentiated papillary adenocarcinoma, 8 moderately differentiated patients, 2 mucinous adenocarcinomas, and 2 patients with cystadenocarcinoma. Of the 4 patients, the cancer only adhered to the superior mesenteric vein - the portal vein. The remaining patients had cancer involving the relevant blood vessel wall, but did not enter the blood vessel. Gastric retention occurred in 2 patients after regional pancreatectomy, and the remaining patients did not have biliary leakage or pancreatic leakage, and no significant bloating and diarrhea occurred. The group of 14 patients were followed up after a maximum follow-up of 5 years, no recurrence of pancreatic cancer, CT and color Doppler ultrasound examination revealed graft graft patency. Conclusions The curative effect of combined revascularization in the treatment of pancreatic cancer is significant, but we should pay attention to the indications of operation and select the appropriate cases strictly.