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目的：以晚期胰头癌患者为手术对象，探讨扩大根治与改良术式，提高切除率及生存率和质量。方法：选择性剖腹探查２０例，其中１８例作了扩大根治，采用门脉血管重建及改良ＣｈｉＩｄ术式间置空肠Ｙ形重建消化道加人工乳头定向套迭。结果：扩大根治切除率为９０％，术后均无胆、胰瘘、大出血等严重并发症及手术死亡，最长生存期达５年，２年存率为５５．６％。结论：切除了原发病灶可以解除病人症状，又可防止癌细胞继续浸润门静脉。一并切除了转移灶，使后续治疗（如腹腔动脉化疗、免疫等）得以顺利进行。
OBJECTIVE: To investigate patients with advanced pancreatic head cancer as an operation object, to explore the method of extended radical and modified surgery, and to increase the resection rate, survival rate, and quality. Methods: Selective exploratory laparotomy was performed in 20 patients, of which 18 cases were treated with extended radical resection, using portal vein revascularization and modified ChiId intraoperative jejunum Y-shaped reconstruction of gastrointestinal tract plus artificial papillary directional nesting. Results: The radical resection rate was 90%. There were no serious postoperative complications such as gallbladder, pancreatic fistula, and hemorrhage and operative mortality. The longest survival period was 5 years, and the 2 year survival rate was 55.6%. Conclusion: Removal of the primary lesion can relieve the patient’s symptoms and prevent the cancer cells from continuing to infiltrate the portal vein. The metastases were removed and the subsequent treatments (such as celiac artery chemotherapy, immunization, etc.) were successfully performed.