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目的 总结胰腺钩突癌的临床特征及诊断治疗 ,以提高对胰腺钩突癌的认识。 方法回顾性分析 1998年 1月～ 2 0 0 0年 12月收治的 4 1例胰腺钩突癌患者的临床资料及诊治情况。 结果上腹痛伴腰背部疼痛、体重减轻、黄疸是胰腺钩突癌的主要临床症状。 36例根治术无手术死亡 ,其中行胰十二指肠切除术加区域淋巴结清扫术 2 5例 ,联合肠系膜上静脉 门静脉或肠系膜上动脉局部切除或节段性切除重建者 11例 ,其中行人造血管置换术 2例 ,腹腔神经丛无水酒精注射加腹腔化疗泵放置加肝活检术 1例 ,胆囊空肠Roux en Y吻合术 2例 ,剖腹探查术 1例 ,未手术 1例。术后生存期为2 0～ 4 4 0个月 ,中位生存期 11 2个月 ,健在 4例 ,最长者 4 4 0个月 ,术后 1年生存率 37 0 % ,3年生存率 3 7%。 结论 胰腺钩突癌虽然早期诊断困难、易侵犯周围血管、预后较差 ,只是与肿瘤解剖位置有关 ,而非肿瘤侵袭性行为 ,其有相当高 (87 8% )的手术切除率。
Objective To summarize the clinical features and diagnosis and treatment of pancreatic uncinate carcinoma to improve the understanding of pancreatic uncinate carcinoma. Methods The clinical data and diagnosis and treatment of 41 patients with pancreatic uncinate carcinoma admitted to our hospital from January 1998 to December 2000 were retrospectively analyzed. Results upper abdominal pain with low back pain, weight loss, jaundice is the main clinical manifestations of pancreatic uncinate carcinoma. Thirty-six cases underwent radical surgery without surgery, in which 25 cases underwent pancreaticoduodenectomy combined with regional lymph node dissection, and 11 cases underwent resection or segmentectomy with portal vein or superior mesenteric artery in superior mesenteric vein 2 cases of vascular replacement, celiac plexus injection of alcohol plus intraperitoneal chemotherapy pump placed liver biopsy in 1 case, Roux en Y choledocho-jejunostomy in 2 cases, laparotomy in 1 case, no surgery in 1 case. Postoperative survival was 20 to 44 months. The median survival time was 11 months. The median survival time was 4 months. The longest survival time was 4 40 months. The 1-year survival rate was 37.0% and the 3-year survival rate 3 7%. Conclusions Although the early diagnosis of pancreatic uncinate carcinoma is easy to invade the surrounding blood vessels, the prognosis is poor. It is only related to the anatomy of the tumor, but not to aggressive behavior of the tumor. It has a high surgical resection rate (87.8%).