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目的评价姑息性外科手术在无法切除的晚期壶腹周围癌治疗中的作用。方法对我院1998年6月至2008年6月期间接受姑息性外科手术治疗的292例晚期壶腹周围癌患者的临床资料进行回顾性分析。结果 292例患者中,术后死亡率及并发症发生率分别为0.7%(2/292)及24.0%(70/292),平均存活时间10.3个月。有243例(83.2%)患者术后总胆红素完全降至正常,有39例(13.4%)患者总胆红素较术前降低一半以上,总有效率为96.6%(282/292)。结论对于无法切除的晚期壶腹周围癌,姑息性外科手术是一种安全、有效的治疗方法,手术方式以Roux-en-Y胆管空肠吻合联合胃空肠吻合为宜。
Objective To evaluate the role of palliative surgery in the treatment of unresectable periampullary carcinoma. Methods The clinical data of 292 patients with advanced periampullary carcinoma who underwent palliative surgery between June 1998 and June 2008 in our hospital were analyzed retrospectively. Results Among 292 patients, postoperative mortality and complication rates were 0.7% (2/292) and 24.0% (70/292), respectively. The mean survival time was 10.3 months. Total bilirubin was completely reduced to normal in 243 patients (83.2%). Total bilirubin was reduced by more than half in 39 (13.4%) patients and the total effective rate was 96.6% (282/292). Conclusions Palliative surgery is a safe and effective method for the treatment of unresectable periampullary carcinoma. Roux-en-Y cholangiojejunostomy combined with gastrojejunostomy is the best choice for this procedure.