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目的探讨原发性十二指肠乳头癌的诊断及外科治疗方法。方法回顾性分析2002年1月至2008年12月期间经手术治疗的54例原发性十二指肠乳头癌患者的临床资料。结果行纤维十二指肠镜检查37例,行ERCP检查35例,准确率均为100%。44例行胰十二指肠切除术,10例行姑息性减黄手术。手术均顺利完成,术后出现胰漏6例,腹腔及切口感染2例,出血2例,肺部感染1例,漏胆1例。患者术后1、3及5年的累积生存率分别为68%、50%及29%。结论纤维十二指肠镜及ERCP是诊断十二指肠乳头肿瘤最有效的检查方法,早期诊断、早期选择合理的根治性切除手术是治疗的关键。
Objective To investigate the diagnosis and surgical treatment of primary duodenal papillary carcinoma. Methods The clinical data of 54 patients with primary duodenal papillary carcinoma treated surgically from January 2002 to December 2008 were retrospectively analyzed. Results 37 cases of fiber duodenoscopy, ERCP 35 cases, the accuracy rate was 100%. Forty-four patients underwent pancreaticoduodenectomy and 10 underwent palliative surgery. Surgery was successfully completed, postoperative pancreatic leakage occurred in 6 cases, 2 cases of abdominal and incision infection, bleeding in 2 cases, 1 case of lung infection, 1 case of missed bile. The cumulative 1,3 and 5-year cumulative survival rates were 68%, 50% and 29%, respectively. Conclusion Fiber duodenoscopy and ERCP are the most effective methods for the diagnosis of duodenal papillary tumors. Early diagnosis and early radical surgery are the keys to treatment.