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目的探讨胰头癌切除联合腹膜后淋巴清扫的价值及意义。方法排除随访不全及术后接受辅助治疗的病人后,收入1994-1997年以标准胰十二指肠切除(仅清扫胰周淋巴结,整块切除标本)治疗的胰头癌病人20例,1998-2001以标准手术联合腹膜后淋巴清扫治疗的病人28例,回顾性研究两组病人的临床病理资料,比较术后合并症及术后生存期等临床指标的差异。结果两组临床病理资料具有可比性,扩大根治组标本内淋巴结数量大于标准手术组(P<0.05),腹膜后淋巴结阳性率为21.43%(6/28)。两组术中输血量、术后合并症及总的术后生存期无显著性差异,两组各有1例围手术期死亡病人。比较淋巴结阳性病人的术后生存期,扩大根治组长于标准手术组(P<0.05)。扩大根治组可见腹泻、淋巴漏等术后合并症。结论胰头癌切除联合腹膜后淋巴清扫未增加术后合并症,可改善淋巴结阳性病人的术后生存期。
Objective To investigate the value and significance of pancreatic head cancer resection combined with retroperitoneal lymphadenectomy. Methods Excluding patients with incomplete follow-up and postoperative adjuvant therapy, 20 patients with pancreatic head cancer who were treated with standard pancreatoduodenectomy (pancreas lymph node dissection, lump removal only), 1994-1997, In 2001, 28 cases were treated by standard operation combined with retroperitoneal lymphadenectomy. The clinical and pathological data of two groups of patients were retrospectively analyzed. The differences of clinical indexes such as postoperative complications and postoperative survival were compared. Results The clinicopathological data of the two groups were comparable. The number of lymph nodes in the extended radical group was larger than that of the standard surgery group (P <0.05). The positive rate of retroperitoneal lymph node was 21.43% (6/28). There was no significant difference between the two groups in the amount of blood transfusion, postoperative complications and overall postoperative survival. There were 1 perioperative deaths in each group. The survival of patients with lymph node positive was compared with that of the standard operation group (P <0.05). Enlarge radical group visible diarrhea, lymphatic drainage and other postoperative complications. Conclusion Pancreatic cancer resection combined with retroperitoneal lymphadenectomy does not increase the postoperative complications, can improve the postoperative survival of lymph node-positive patients.