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目的 探讨更 好地解决胰头癌姑息性手术的问题。方法 对近１２年收治的７３例胰 头癌患者，在不同时期，采取不同手术方式实施姑息性手术治疗进行回顾分析。 结果 单纯胆囊空肠吻合术引流减黄效果不佳；肝（胆）总管空肠Ｒｏｕｘ－Ｙ吻合 减黄效果肯定，但缓解不了十二指肠梗阻；肝（胆）总管空肠Ｒｏｕｘ－Ｙ吻合加作胃空肠吻合 ，减黄效果好，肝功恢复快，且中位生存期（１１．７个月）明显较前两种术式组长（Ｐ＜０． ０１）。结论 在胰头癌姑息性手术治疗方法的选择上，应考虑到双 重梗阻因素，即便尚未明确伴有十二指肠梗阻，预防性加作胃空肠吻合也是必要的。
Objective To explore the problem of palliative surgery for pancreatic head cancer better. Methods 73 cases of pancreatic head cancer patients admitted in the past 12 years were retrospectively analyzed with palliative surgery by different surgical methods at different stages. The results of simple gallbladder jejunostomy drainage less effective; Roux-Y hepatic (Gall) jejunum jejunal reduction effect of affirmation, but can not alleviate duodenal obstruction; Roux-Y jejunum of the common bile duct plus stomach Jejunum anastomosis, the effect of reducing yellow, liver function recovered quickly, and the median survival time (11.7 months) was significantly longer than the previous two groups (P <0.01). Conclusions The choice of palliative surgery for pancreatic head cancer should take into account the double obstruction, and prophylactic plus gastrojejunostomy is necessary even if it is not yet clearly associated with duodenal obstruction.