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目的探讨原发性十二指肠腺癌生物学特征及外科治疗问题。方法回顾性分析近20年31例十二指肠腺癌患者临床资料。结果13例术前胃镜检查，12例发现病变，诊断丰92．3％；上消化道钡餐13例，阳性发现IO例，诊断率76．92％。胰十二指肠切除17例，十二指肠节段切除5例，姑息性旁路手术9例。手术切除率70．98％，近期合并症12．9％。肿瘤侵犯十H指肠壁全层及胰腺组织15例（68．18％），淋巴结转移率500％（11／22）。9例姑息性手术，8例1年内死亡，l例存活2年4个月。17例胰十二指肠切除者，随诊2年发现肝转移6例，其中4例初次手术淋巴结转移。5例十二指肠节段切除者，2例失访，2例肿瘤1年内复发死亡，l例死于非肿瘤疾病。结论十二指肠癌病变隐匿，恶性程度较高，早期诊断及选择根治性的切除手术有望提高临床治疗效果。
Objective To explore the biological characteristics and surgical treatment of primary duodenal adenocarcinoma. Methods The clinical data of 31 patients with duodenal adenocarcinoma in the past 20 years were retrospectively analyzed. [Results] 13 cases of gastroscopy before operation, 12 cases found lesions, diagnosis of Feng 92.3%; 13 cases of upper gastrointestinal barium meal, positive found IO cases, the diagnostic rate of 76.92%. Pancreatoduodenectomy was performed in 17 cases, duodenal segment resection in 5 cases, and palliative bypass surgery in 9 cases. The surgical resection rate was 70.98% and the recent complication was 12.9%. Tumor invasion of ten H refers to the full thickness of the intestinal wall and pancreatic tissue in 15 cases (68.18%), and the lymph node metastasis rate was 500% (11/22). Nine cases of palliative surgery, 8 cases died within 1 year, 1 case survived 2 years and 4 months. In 17 cases of pancreatoduodenectomy, 6 cases of hepatic metastasis were found following follow-up for 2 years, 4 cases of primary lymph node metastasis. In 5 cases of resection of duodenal segment, 2 cases lost follow-up, 2 cases of tumors relapsed within 1 year, and 1 case died of non-neoplastic diseases. [Conclusion] The duodenal cancer lesions are occult and have a high degree of malignancy. Early diagnosis and selective curative resection are expected to improve clinical treatment.