论文部分内容阅读
本文报道2例经胰十二指肠切除治愈的壶腹癌患者,于术后5年、15年在胆管空肠吻合口发生第二次原发癌。病例Ⅰ.男,40岁。1973年行胰十二指肠切除,肿瘤3.5cm,来源于壶腹上皮并浸润十二指肠肌层,为中分化浸润腺癌。切缘无癌细胞。1988年出现腹痛、发热。CT 提示肝内外胆管扩张。经皮穿刺胆道造影见远端胆管充盈缺损。内镜证实胆管空肠吻合口肿瘤,活检为浸润性中等分化的原位癌。第二次手术后随访两年半无复发。病例Ⅱ.女,74岁。1985年行胰十二指肠切除,壶腹部3.5 cm 中等分化的原发癌,浸润但没有穿透
This article reports 2 cases of ampullary cancer patients cured by pancreatoduodenectomy. The second primary cancer occurred in the biliary jejunostomy 5 years and 15 years after operation. Case I. Male, 40 years old. Pancreatoduodenectomy in 1973, tumor 3.5cm, derived from the ampulla epithelium and infiltration of the duodenal muscle, for the differentiation of invasive adenocarcinoma. There is no cancer in the margin. In 1988 there was abdominal pain and fever. CT prompted intrahepatic bile duct dilatation. Percutaneous cholangiography revealed distal bile duct filling defects. Endoscopic examination confirmed biliary jejunostomy tumors. Biopsy was invasive, moderately differentiated, carcinoma in situ. Follow-up after the second surgery was performed for two and a half months without recurrence. Case II. Female, 74 years old. Pancreatoduodenectomy in 1985, 3.5 cm moderately differentiated primary carcinoma in ampulla, infiltrates but not penetrated