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目的总结80岁以上高龄患者施行胰十二指肠切除术的体会。方法回顾性分析3例80岁以上患者施行胰十二指肠切除术的临床资料及随访情况。结果 3例患者手术均获得成功,手术时间分别为340 min、390 min、410 min,术中出血量分别为300 ml、800 ml、1 000 ml,分别于术后42 d、51 d、83 d康复出院。围手术期2例发生并发症,其中胃瘫2例,肺部感染、深静脉导管菌血症、上消化道出血各1例,无胰瘘、腹腔出血和腹腔感染者。3例均康复出院,无围手术期死亡。2例分别于术后5个月、13个月因腹膜后淋巴结转移而死亡,另1例术后随诊53个月,肿瘤无复发、转移,生活质量良好。结论高龄不是胰十二指肠切除术的禁忌证,只要具备熟练的专科手术技能及围手术期综合救治能力,80岁以上高龄患者仍可安全施行胰十二指肠切除术,并获得较好的治疗效果。
Objective To summarize the experience of pancreaticoduodenectomy in patients over 80 years of age. Methods Retrospective analysis of 3 cases of patients over 80 years of age undergoing pancreatoduodenectomy clinical data and follow-up. Results All the three cases were operated successfully. The operative time was 340 min, 390 min and 410 min respectively. The intraoperative blood loss was 300 ml, 800 ml and 1 000 ml respectively. The operative time was 42 d, 51 d and 83 d Rehabilitation discharged. Perioperative complications occurred in 2 cases, including 2 cases of gastric paralysis, pulmonary infection, deep vein catheter bacteremia, upper gastrointestinal bleeding in 1 case, no pancreatic fistula, celiac hemorrhage and abdominal infection. Three patients were discharged from hospital without perioperative death. 2 cases died of retroperitoneal lymph node metastasis 5 months and 13 months after operation, respectively. The other one was followed up 53 months after operation. The tumor had no recurrence and metastasis, and the quality of life was good. Conclusion Elderly is not a contraindication to pancreaticoduodenectomy. As long as the patients with advanced age over 80 years old can safely perform pancreaticoduodenectomy with good specialist surgical skills and comprehensive perioperative treatment, Therapeutic effect.