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目的 提高局部进展期胰腺癌的根治性切除率并改善其预后。方法 对 1997～ 2 0 0 3年 2 6例单纯侵犯门静脉 (PV )和 (或 )肠系膜上静脉 (SMV )的局部进展期胰腺癌施行受侵PV及SMV在内的整块联合切除术。结果 16例 (61 5% )获根治性切除 ,10例获姑息切除。围手术期并发症 8例 (3 0 7% ) ,死亡 1例 (3 8% )。获根治性切除的 16例中 ,术后 1、3、5年生存率分别是 68 8% (n =11)、2 6 7% (n =4)和 6 3 % (n =1) ,但姑息切除者术后平均生存仅 5 6个月。结论 对于局部进展期胰腺癌 ,选择合适的病例施行受侵PV及SMV联合切除是安全可行的 ,获根治性切除者预后显著改善
Objective To improve the radical resection rate and improve the prognosis of locally advanced pancreatic cancer. Methods Monolithic resection of invasive PV and SMV was performed in locally advanced pancreatic adenocarcinoma of 26 patients with simple invasion of portal vein (PV) and / or superior mesenteric vein (SMV) from 1997 to 2003. Results 16 cases (61.5%) were treated by radical resection and 10 cases were treated by palliative resection. Perioperative complications in 8 cases (30%), 1 died (38%). Of the 16 patients who underwent radical resection, the 1, 3, 5 year survival rates were 68.8% (n = 11), 267% (n = 4) and 63% (n = 1) Palliative surgery average postoperative survival of only 5 6 months. Conclusions For locally advanced pancreatic cancer, it is safe and feasible to select the appropriate cases for combined PV and SMV resection, and the prognosis of radical resection is significantly improved