姑息性外科手術在晚期壺腹周圍癌治療中的作用_《中國普外基礎與臨床雜志》

作者：

陳濤 , 湯禮軍 , 田伏洲 , 向珂 , 石力 , 崔建峰

成都軍區總醫院全軍普通外科中心(四川成都 610083);

關鍵詞：

壺腹周圍癌姑息性外科手術

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目的評價姑息性外科手術在無法切除的晚期壺腹周圍癌治療中的作用。方法對我院1998年6月至2008年6月期間接受姑息性外科手術治療的292例晚期壺腹周圍癌患者的臨床資料進行回顧性分析。結果292例患者中，術后死亡率及并發癥發生率分別為0.7%(2/292)及24.0%(70/292)，平均存活時間10.3個月。有243例(83.2%)患者術后總膽紅素完全降至正常，有39例(13.4%)患者總膽紅素較術前降低一半以上，總有效率為96.6%(282/292)。結論對于無法切除的晚期壺腹周圍癌，姑息性外科手術是一種安全、有效的治療方法，手術方式以Roux-en-Y膽管空腸吻合聯合胃空腸吻合為宜。

引用本文： 陳濤,湯禮軍,田伏洲,向珂,石力,崔建峰. 姑息性外科手術在晚期壺腹周圍癌治療中的作用. 中國普外基礎與臨床雜志, 2011, 18(4): 423-425. doi: 復制

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2.	Katsinelos P, Paikos D, Kountouras J, et al. Tannenbaum and metal stents in the palliative treatment of malignant distal bile duct obstruction: a comparative study of patency and costeffectiveness [J]. Surg Endosc, 2006, 20(10): 15871593.
3.	龔彪. 經內鏡膽道金屬支架引流術治療惡性膽道梗阻的價值-附786例報告 [J]. 中國消化內鏡, 2007, 1(1): 2022.
4.	勾承月, 秦鳴放, 王慶, 等. 膽道支架介入治療惡性膽道梗阻136例臨床分析 [J]. 中國微創外科雜志, 2010, 10(5): 412414.
5.	辛波, 張林波, 姜喜遠, 等. 惡性梗阻性黃疸介入治療與手術引流比較 [J]. 中國普外基礎與臨床雜志, 2010, 17(3): 233236.
6.	范震, 張嘯, 張筱鳳, 等. ERCP放置膽管內支架姑息治療難以切除的惡性膽管梗阻 [J]. 現代消化及介入治療, 2007, 12(1): 13.
7.	Dahlstrand U, Sandblom G, Eriksson LG, et al. Primary patency of percutaneously inserted selfexpanding metallic stents in patients with malignant biliary obstruction [J]. HPB (Oxford), 2009, 11(4): 358363.
8.	Kahaleh M, Tokar J, Conaway MR, et al. Efficacy and complications of covered Wallstents in malignant distal biliary obstruction [J]. Gastrointest Endosc, 2005, 61(4): 528533.
9.	Lee CK, Barrios B, Bjarnason H. Biliary tree malignancies: the University of Minnesota experience [J]. J Surg Oncol, 1997, 65(4): 298305.
10.	Lesurtel M, Dehni N, Tiret E, et al. Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal [J]. J Gastrointest Surg, 2006, 10(2): 286291.
11.	Singh S, Sachdev AK, Chaudhary A, et al. Palliative surgical bypass for unresectable periampullary carcinoma [J]. Hepatobiliary Pancreat Dis Int, 2008, 7(3): 308312.
12.	Kuhlmann KF, van Poll D, de Castro SM, et al. Initial and longterm outcome after palliative surgical drainage of 269 patients with malignant biliary obstruction [J]. Eur J Surg Oncol, 2007, 33(6): 757762.
13.	夏焱, 朱玉華, 張彪. 經內鏡放置自膨式不帶膜金屬支架治療膽管中下段惡性狹窄的療效觀察 [J]. 中國普外基礎與臨床雜志, 2004, 11(2): 151153.
14.	李海洋, 孫誠誼, 潘耀振, 等. 不同途徑膽道支架置入治療惡性梗阻性黃疸42例回顧分析 [J]. 中國普外基礎與臨床雜志, 2009, 16(4): 300303.
15.	Kim HO, Hwang SI, Kim H, et al. Quality of survival in patients treated for malignant biliary obstruction caused by unresectable pancreatic head cancer: surgical versus nonsurgical palliation [J]. Hepatobiliary Pancreat Dis Int, 2008, 7(6): 643648.
16.	Lillemoe KD, Cameron JL, Hardacre JM, et al. Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? A prospective randomized trial [J]. Ann Surg, 1999, 230(3): 322328.
17.	Shyr YM, Su CH, Wu CE, et al. Prospective study of gastric outlet obstruction in unrestable periampillary adenocarcinoma [J]. World J Surg, 2000, 24(1): 6065.
18.	Liu YB, Huang L, Xian ZY, et al. Surgical treatment of patients with intermediateterminal pancreatic cancer [J]. World J Gastroenteral, 2006, 12(5): 765767.
19.	Van Heek NT, De Castro SM, van Eijck CH, et al. The need for a prophylactic gastrojejunostomy for unresectable periampullary cancer: a prospective randomized multicenter trial with special focus on assessment of quality of life [J]. Ann Surg, 2003, 238(6): 894905.
20.	付金強, 雷正明. 預防性胃腸轉流在晚期壺腹周圍癌外科治療中的價值 [J]. 中華普通外科學文獻(電子版), 2007, 1(2): 6774.

1. Watanapa P, Williamson RC. Surgical palliation for pancreatic cancer: developments during the past two decades [J]. Br J Surg, 1992, 79(1): 820.
2. Katsinelos P, Paikos D, Kountouras J, et al. Tannenbaum and metal stents in the palliative treatment of malignant distal bile duct obstruction: a comparative study of patency and costeffectiveness [J]. Surg Endosc, 2006, 20(10): 15871593.
3. 龔彪. 經內鏡膽道金屬支架引流術治療惡性膽道梗阻的價值-附786例報告 [J]. 中國消化內鏡, 2007, 1(1): 2022.
4. 勾承月, 秦鳴放, 王慶, 等. 膽道支架介入治療惡性膽道梗阻136例臨床分析 [J]. 中國微創外科雜志, 2010, 10(5): 412414.
5. 辛波, 張林波, 姜喜遠, 等. 惡性梗阻性黃疸介入治療與手術引流比較 [J]. 中國普外基礎與臨床雜志, 2010, 17(3): 233236.
6. 范震, 張嘯, 張筱鳳, 等. ERCP放置膽管內支架姑息治療難以切除的惡性膽管梗阻 [J]. 現代消化及介入治療, 2007, 12(1): 13.
7. Dahlstrand U, Sandblom G, Eriksson LG, et al. Primary patency of percutaneously inserted selfexpanding metallic stents in patients with malignant biliary obstruction [J]. HPB (Oxford), 2009, 11(4): 358363.
8. Kahaleh M, Tokar J, Conaway MR, et al. Efficacy and complications of covered Wallstents in malignant distal biliary obstruction [J]. Gastrointest Endosc, 2005, 61(4): 528533.
9. Lee CK, Barrios B, Bjarnason H. Biliary tree malignancies: the University of Minnesota experience [J]. J Surg Oncol, 1997, 65(4): 298305.
10. Lesurtel M, Dehni N, Tiret E, et al. Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal [J]. J Gastrointest Surg, 2006, 10(2): 286291.
11. Singh S, Sachdev AK, Chaudhary A, et al. Palliative surgical bypass for unresectable periampullary carcinoma [J]. Hepatobiliary Pancreat Dis Int, 2008, 7(3): 308312.
12. Kuhlmann KF, van Poll D, de Castro SM, et al. Initial and longterm outcome after palliative surgical drainage of 269 patients with malignant biliary obstruction [J]. Eur J Surg Oncol, 2007, 33(6): 757762.
13. 夏焱, 朱玉華, 張彪. 經內鏡放置自膨式不帶膜金屬支架治療膽管中下段惡性狹窄的療效觀察 [J]. 中國普外基礎與臨床雜志, 2004, 11(2): 151153.
14. 李海洋, 孫誠誼, 潘耀振, 等. 不同途徑膽道支架置入治療惡性梗阻性黃疸42例回顧分析 [J]. 中國普外基礎與臨床雜志, 2009, 16(4): 300303.
15. Kim HO, Hwang SI, Kim H, et al. Quality of survival in patients treated for malignant biliary obstruction caused by unresectable pancreatic head cancer: surgical versus nonsurgical palliation [J]. Hepatobiliary Pancreat Dis Int, 2008, 7(6): 643648.
16. Lillemoe KD, Cameron JL, Hardacre JM, et al. Is prophylactic gastrojejunostomy indicated for unresectable periampullary cancer? A prospective randomized trial [J]. Ann Surg, 1999, 230(3): 322328.
17. Shyr YM, Su CH, Wu CE, et al. Prospective study of gastric outlet obstruction in unrestable periampillary adenocarcinoma [J]. World J Surg, 2000, 24(1): 6065.
18. Liu YB, Huang L, Xian ZY, et al. Surgical treatment of patients with intermediateterminal pancreatic cancer [J]. World J Gastroenteral, 2006, 12(5): 765767.
19. Van Heek NT, De Castro SM, van Eijck CH, et al. The need for a prophylactic gastrojejunostomy for unresectable periampullary cancer: a prospective randomized multicenter trial with special focus on assessment of quality of life [J]. Ann Surg, 2003, 238(6): 894905.
20. 付金強, 雷正明. 預防性胃腸轉流在晚期壺腹周圍癌外科治療中的價值 [J]. 中華普通外科學文獻(電子版), 2007, 1(2): 6774.

《中國普外基礎與臨床雜志》

姑息性外科手術在晚期壺腹周圍癌治療中的作用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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《中國普外基礎與臨床雜志》

姑息性外科手術在晚期壺腹周圍癌治療中的作用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料