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目的：探讨胰头癌根治术加区域淋巴结廓清对提高手术根治效果和生存率的作用。方法：对２１例胰头癌患者在胰十二指肠切除术（Ｗｈｉｐｐｌｅ）基础上，扩大手术切除的范围，有针对性地进行区域淋巴结廓清。分析其临床和病理资料，并进行随访观察。结果：全组无手术死亡及严重并发症发生，有１１例（５２％ ）患者存在淋巴结转移。其中，淋巴结癌转移率以肠系膜根部（１４组）和胰头后（１３组）最高，其次为胰头前（１７ 组）、肝动脉旁（８ 组）和肝十二指肠韧带（１２ 组）。术后３ 例发生轻中度腹泻。随访病例中有１ 例在术后３ 个月因严重腹泻治疗不当死亡，１例术后５ 个月发生肝转移，其余病例均存活。结论：附加区域淋巴结廓清的胰头癌根治术风险并无明显增加，但根治效果良好，存活时间延长，虽尚需进一步扩大样本和延长随访时间，但其前景令人鼓舞。
Objective: To investigate the role of radical pancreatic cancer plus clearance of regional lymph nodes in improving radical surgery and survival. METHODS: Twenty-one patients with pancreatic head cancer were performed on the basis of pancreaticoduodenectomy (Whipple) to expand the range of surgical resection and targeted regional lymph node dissection. Clinical and pathological data were analyzed and follow-up observations were performed. Results: There were no operative deaths and serious complications in the whole group. There were lymph node metastases in 11 (52%) patients. Among them, the metastatic rates of lymph node metastasis were highest in the mesenteric root (14 groups) and the posterior pancreatic head (13 groups), followed by the pancreatic head (17 groups), the hepatic artery (8 groups), and the hepatoduodenal ligament (12 groups). ). Mild to moderate diarrhea occurred in 3 cases. Among the follow-up cases, 1 patient died of 3 months after treatment due to severe diarrhea, 1 patient developed liver metastasis 5 months after surgery, and all other cases survived. Conclusion: The risk of pancreatic head cancer radical clearance with additional regional lymph nodes is not significantly increased, but the cure effect is good, and the survival time is prolonged. Although it is still necessary to further expand the sample and prolong the follow-up time, its prospects are encouraging.