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目的探讨胰体尾癌的诊断与临床治疗。方法回顾性分析1988—2005年胰体尾癌79例临床资料。结果腺癌70例,黏液腺癌6例,囊腺癌2例,腺鳞癌1例。肿瘤分期(TNM):Ⅰ期2例(2.6%),Ⅱ期20例(25.3%),Ⅲ期23例(29.1%),Ⅳ期34例(43.O%)。75例手术探查,肿块切除27例,48例未切除,切除率36%,基本术式为胰体尾及脾切除,1例保留脾脏;1例全腹腔镜手术;4例未行手术。36例随访资料(至2006年3月)显示:未手术者中3例分别于出院后15 d,1个月,2个月死亡;肿块未切除者中2例术后30 d内死亡,18例平均存活6.1个月;肿块切除者中8例死亡,平均存活16.6个月;5例尚存活。结论早期诊断、根治性手术及合理的辅助治疗是改善胰体尾癌疗效的关键。
Objective To explore the diagnosis and clinical treatment of pancreatic body tail cancer. Methods The clinical data of 79 patients with pancreatic body and tail tumor from 1988 to 2005 were retrospectively analyzed. Results There were 70 cases of adenocarcinoma, 6 cases of mucinous adenocarcinoma, 2 cases of cystadenocarcinoma and 1 case of adenosquamous carcinoma. Tumor stage (TNM): stage Ⅰ in 2 cases (2.6%), stage Ⅱ in 20 cases (25.3%) in stage Ⅲ in 23 cases (29.1%) in stage Ⅳ in 34 cases (43.O%). Seventy-five cases were enrolled in this study. Totally 27 cases were resected and 48 cases were not resected. The resection rate was 36%. The basic operation was pancreatic body tail and splenectomy. One case retained the spleen. One case received total laparoscopic surgery and the other 4 cases did not undergo surgery. Thirty-six follow-up data (up to March 2006) showed that 3 of the non-operative patients died after 15 days, 1 month and 2 months after discharge respectively. Two of the patients with unresectomedial mass died within 30 days after operation, 18 The average survival time was 6.1 months. In the tumor resection, 8 patients died, with an average survival of 16.6 months. Five patients survived. Conclusion Early diagnosis, radical surgery and reasonable adjuvant therapy are the keys to improve curative effect of pancreatic body and tail tumor.