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目的 总结采用留幽门的胰十二指肠切除术 (PPPD)治疗的壶腹周围癌患者的生存情况 ,探讨PP PD的手术彻底性。 方法 将47例PPPD与同期127例经典的胰十二指肠切除术 (PD)作对照研究 ,分析两组患者的术后生存率。 结果 PPPD组与PD组术后并发症发生率分别为34.0 %和27.6% ,差别无显著性意义 (P>0.05) ;中位生存时间分别为31个月和29个月 ;两组生存率曲线比较差别无显著性意义 (P>0.05) ;术后5年生存率分别为38.1%和31.0% ,差别无显著性意义 (P>0.05) ;其中的胰头癌患者 ,5年生存率分别为15.7 %和21.2 % ,差别也无显著性意义 (P>0.05) ;同时发现 ,Ⅰ、Ⅱ期肿瘤患者的5年生存率为46.5% ,而Ⅲ、Ⅳ期肿瘤患者的5年生存率仅为4.6% ,两者差别有显著性意义 (P<0.01)。结论 对于无明显胰外浸润转移的胰头癌及壶腹部癌患者可施行PPPD
Objective To summarize the survival of patients with periampullary carcinoma treated with pylorus-preserving pancreaticoduodenectomy (PPPD) and to investigate the surgical thoroughness of PP-PD. Methods 47 cases of PPPD and 127 cases of classic pancreatoduodenectomy (PD) at the same period as a control study, the two groups of patients after surgery survival rate. Results The incidence of postoperative complications in PPPD group and PD group were 34.0% and 27.6%, respectively, with no significant difference (P> 0.05). The median survival time was 31 months and 29 months respectively. The survival rate curve (P> 0.05). The 5-year postoperative survival rates were 38.1% and 31.0%, respectively, with no significant difference (P> 0.05). The 5-year survival rates of patients with pancreatic head cancer were 15.7% and 21.2%, respectively. There was no significant difference between the two groups (P> 0.05). The 5-year survival rate of patients with stage I and II tumors was 46.5%, while the 5-year survival rates of patients with stage III and IV tumors were only 4.6%, the difference between the two was significant (P <0.01). Conclusion PPPD can be performed in patients with pancreatic cancer and ampullary carcinoma without obvious metastasis to pancreatic carcinoma