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目的:对胰腺癌手术切除术和姑息性转流术者的疗效作一回顾性多因素分析比较.方法:1982一1988年,全组共计3741例胰腺癌手术病例,其中行手术切除787例,姑息性转流术2444例,单纯剖腹探查510例,考虑到影响术后死亡率及手术切除和转流术生存率诸因素,作Logistic逐步回归和Log-rank检验分析.结果:切除术和转流术的术后死亡率分别为10%和15%(P<0.001).平均生存时间分别为19.5月(标准误1.1)和8.8月(标准误0.3)(P<0.001).对无内脏转移及远处淋巴结转移者,切除术的生存率较姑息性转流术为高(P<0.001).结论:凡内脏无转移的胰腺癌,只要无手术禁忌证及技术可行均应作手术切除.
OBJECTIVE: To retrospectively compare and analyze the efficacy of surgical resection and palliative pancreatitis in patients with pancreatic cancer. Methods: From 1982 to 1988, a total of 3741 pancreatic cancer cases were performed in the entire group, of which 787 were surgically removed. Palliative complications were performed in 2,444 cases and simple laparotomy was performed in 510 cases. Logistic stepwise regression and Log-rank test analysis were performed in consideration of factors affecting postoperative mortality and surgical resection and bypass surgeries. Results: Resection and transfer The postoperative mortality was 10% and 15%, respectively (P < 0.001). The mean survival time was 19.5 months (standard error 1.1) and 8.8 months (standard error 0.3) (P <0.001). There was no visceral metastasis. In patients with distant lymph node metastasis, the survival rate of resection was higher than that of palliative bypass surgery (P<0.001). Conclusion: All pancreatic cancer without metastasis should be surgically resected as long as no surgical contraindication and technical feasibility are available.