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目的探讨高龄十二指肠乳头部肿瘤患者局部切除的可行性及合理性。方法回顾性分析1998-2004年在我院行局部切除治疗的12例高龄十二指肠乳头部肿瘤患者的临床资料。结果12例患者术前B超和CT均显示肝内外胆管扩张。全组均采用经十二指肠肿瘤局部切除术,无手术死亡。术后病理活检结果发现1例低分化、10例中、高分化腺癌。11例(91.6%)患者获1-3年随访。1例低分化腺癌患者术后10个月肿瘤复发死亡;7例存活时间分别达13、14、22、26、27、30、36个月,余3例患者仍存活至今。结论肿瘤局部切除术对高龄十二指肠乳头部癌患者是一种安全、有效、合理的术式选择
Objective To investigate the feasibility and rationality of local resection of elderly patients with duodenal papillary tumors. Methods We retrospectively analyzed the clinical data of 12 elderly patients with duodenal papillary tumor who underwent local resection in our hospital from 1998 to 2004. [Results] B-ultrasonography and CT scan before and after operation in 12 patients showed intrahepatic and extrahepatic bile duct dilatation. All patients were treated with local resection of duodenal tumors and no operative death occurred. Postoperative biopsy results revealed one case of poorly differentiated, 10 cases of moderately-differentiated adenocarcinoma. Eleven patients (91.6%) were followed up for 1-3 years. One patient with poorly differentiated adenocarcinoma died of tumor recurrence 10 months after surgery; 7 patients survived for 13, 14, 22, 26, 27, 30, and 36 months, respectively, and the remaining 3 patients survived to this day. Conclusion Local tumor resection is a safe, effective and reasonable choice for elderly patients with duodenal papillary carcinoma.