论文部分内容阅读
目的 探讨老年患者胰腺癌接受胰十二指肠切除术,以期明确手术成功的相关因素。方法 本研究包括74例大胰癌患者。35例年龄大于70岁,30例为标准胰十二指肠切除术和5例为区域性胰十二指肠切除术,其中15例按“三步法”予以切除。这组患者的结果与另外39例非老年患者作比较。结果 老年患者的30天手术死亡率与并发症率分别为5.9％和26.4％;而在非老年患者中分别为5.2％和18.4％。危险因素、并发症率和死亡率差别有统计学意义。老年患者和非老年患者的5年生存率分别为11.7％和15.7％,无显著性差异。结论 本研究表明老年患者可安全接受根治性胰十二指肠切除术,而长期效果与非老年患者相似。减黄可改善肝、肾功能,增加患者对手术的耐受。术前介入化疗可在肿瘤与门静脉间产生“炎性水帘”,从而减少门静脉切除率。
Objective To investigate pancreatic cancer in elderly patients undergoing pancreatoduodenectomy in order to clarify the relevant factors of surgical success. Methods This study included 74 patients with large pancreatic cancer. Thirty-five patients older than 70 years old, 30 patients underwent standard pancreatoduodenectomy and 5 patients underwent regional pancreatoduodenectomy. Among them, 15 patients underwent resection by the three-step method. The results of this group of patients compared with 39 other non-elderly patients. Results The 30-day mortality rate and complication rate of elderly patients were 5.9% and 26.4% respectively, while those of non-elderly patients were 5.2% and 18.4% respectively. The risk factors, complication rate and mortality difference were statistically significant. The 5-year survival rates of elderly patients and non-elderly patients were 11.7% and 15.7% respectively, with no significant difference. Conclusions This study shows that elderly patients can safely undergo radical pancreaticoduodenectomy with similar long-term outcomes as non-elderly patients. Reduce the liver can improve liver and kidney function, increase patient tolerance to surgery. Preoperative intervention chemotherapy in the tumor and portal vein to produce “inflammatory curtain”, thereby reducing the rate of portal vein resection.