论文部分内容阅读
目的:探讨胰十二指肠切除术(Whipple术)在胆管下段癌治疗中的临床效果。方法:选取本院2008年12月至2014年4月手术治疗的72例胆管下段癌患者进行回顾性分析,其中37例患者采用Whipple手术治疗(Whipple组)、35例患者采用保留幽门的胰十二指肠切除术(PPPD组),对比两组的临床效果差异。结果:PPPD组患者的手术时间显著短于Whipple组且差异具有统计学意义(P<0.05);PPPD组患者的恢复半流质饮食的时间显著长于Whipple组且差异具有统计学意义(P<0.05);PPPD组患者与Whipple组患者术后3、7 d的白蛋白、血红蛋白水平差异无统计学意义(P>0.05);PPPD组患者的手术并发症率14.29%显著低于Whipple组患者的35.14%(P<0.05);PPPD组患者术后1年生存率71.43%、2年生存率54.29%,与Whipple组患者的75.66%、59.46%差异无统计学意义(P>0.05)。结论:对于具有PPPD手术指征的胆管下段癌患者采用PPPD手术与Whipple手术治疗均具有较好的临床效果,但PPPD手术具有并发症率更低的优势。
Objective: To investigate the clinical effect of Whipple operation in the treatment of lower bile duct cancer. Methods: A retrospective analysis was performed on 72 patients with lower biliary ductal carcinoma undergoing surgical treatment from December 2008 to April 2014 in our hospital. Of the 37 patients treated with Whipple’s surgery (Whipple group), 35 patients had pancreatic pyloric retention pylori The cases of duodenal resection (PPPD group) were compared with those of the two groups. Results: The operation time of patients in PPPD group was significantly shorter than that of Whipple group (P <0.05). The time of recovery of semi-liquid diet in PPPD group was significantly longer than that in Whipple group (P <0.05) ; There was no significant difference in albumin and hemoglobin levels between the PPPD group and the Whipple group 3 and 7 days postoperatively (P> 0.05). The complication rate of PPPD group was 14.29%, which was significantly lower than that of the Whipple group (35.14% (P <0.05). The 1-year survival rate and the 2-year survival rate were 71.43% and 54.29% respectively in the PPPD group compared with those in the Whipple group (75.66% and 59.46%, P <0.05). CONCLUSIONS: Both PPPD and Whipple surgery are effective in patients with lower biliary duct cancer who have indications for PPPD. However, PPPD has the advantage of lower complication rate.