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目的探讨局部进展期胃癌或结肠癌行胃癌或结肠癌切除联合胰十二指肠切除术的可行性及临床价值。方法回顾性分析2004年5月—2010年12月15例侵犯胰头十二指肠区域的局部进展期胃癌或结肠癌联合胰十二指肠切除术患者的临床资料,其中原发或复发胃癌12例,结肠癌3例。结果中位手术时间6 h(4～12 h),中位术后住院时间21 d(7～63 d)。并发症发生率为46.7%(7/15),再手术率为6.7%(1/15),病死率为6.7%(1/15)。中位生存期为23个月;1,2,3年累积生存率分别为62.2%,44.4%,22.2%。结论联合胰十二指肠切除术可作为局部进展期胃癌或结肠癌侵犯胰头十二指肠区域患者的治疗选择。该术式可延长部分患者的生存期。
Objective To investigate the feasibility and clinical value of resection of gastric cancer or colon cancer combined with pancreatoduodenectomy in locally advanced gastric cancer or colon cancer. Methods The clinical data of 15 patients with locally advanced gastric cancer or colon cancer combined with pancreatoduodenectomy who invaded the duodenum of the pancreas head from May 2004 to December 2010 were retrospectively analyzed. Among them, primary or recurrent gastric cancer 12 cases, 3 cases of colon cancer. Results The median operation time was 6 h (4 ~ 12 h) and the median postoperative hospital stay was 21 d (7 ~ 63 d). The complication rate was 46.7% (7/15), the rate of reoperation was 6.7% (1/15) and the case fatality rate was 6.7% (1/15). The median survival time was 23 months. The cumulative survival rates at 1, 2 and 3 years were 62.2%, 44.4% and 22.2%, respectively. Conclusions Combined pancreatoduodenectomy may be a treatment option for patients with locally advanced gastric cancer or colon cancer invading the duodenum of the pancreas. The procedure can extend the survival of some patients.