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报告12例胃下部癌行根治性胰头十二指肠切除术(RPD),取得了满意的临床效果。认为胃下部癌侵及胰头和(或)十二指肠者为绝对适应证。而N3(+)者为相对适应证,第16组淋巴结转移者应放弃RPD。淋巴结的清除范围达D_3即可。适应证的选择应从严掌握,须结合病人的年龄、一般状况、重要脏器功能及经济条件等因素综合考虑。对胃癌侵及胰腺和淋巴结转移的判定应慎重,必要时需行冰冻活检。并对该手术的有关问题进行讨论。
Reported 12 cases of gastric cancer underwent radical pancreaticoduodenectomy (RPD), and achieved satisfactory clinical results. It is considered that the invasion of the lower stomach to the head of the pancreas and/or the duodenum is an absolute indication. The N3(+) is a relative indication, and the 16th group of lymph node metastases should abandon the RPD. Removal of lymph nodes can reach D_3. The selection of indications should be strictly controlled and must be considered in conjunction with the patient’s age, general conditions, vital organ functions, and economic conditions. The judgment of gastric cancer invading the pancreas and lymph node metastasis should be cautious, if necessary, need to perform the frozen biopsy. And discuss the relevant issues of the surgery.