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目的探讨对晚期胰腺癌行内镜腹腔镜联合姑息治疗的可行性和临床疗效。方法2002年2月至2004年12月,对32例晚期胰腺癌病人行内镜鼻胆管引流(ENBD)减黄后,联合腹腔镜胆肠、胃肠内引流术治疗,并观察其临床疗效。结果32例病人,ENBD和腹腔镜手术均获成功。手术历时70～181min,出血35～220mL,术后3～5d胃肠功能恢复,住院9～24d。术后病人黄疸逐渐消退、肝功能得到改善,恢复经口饮食。术后有1例发生切口感染,无其他手术并发症。结论腹腔镜胆肠、胃空肠吻合联合ENBD姑息治疗晚期胰腺癌可行、有效,具有创伤小、减黄彻底、术后痛苦轻、住院时间短等优点。
Objective To investigate the feasibility and clinical efficacy of endoscopic laparoscopy combined with palliative treatment for advanced pancreatic cancer. Methods From February 2002 to December 2004, 32 patients with advanced pancreatic cancer underwent endoscopic nasobiliary drainage (ENBD) reduction and combined with laparoscopic choledochojejunostomy and gastrointestinal drainage. The clinical effects were observed. Results 32 patients, ENBD and laparoscopic surgery were successful. Surgery lasted 70 ~ 181min, bleeding 35 ~ 220mL, 3 ~ 5d after gastrointestinal function recovery, hospital 9 ~ 24d. After the patient jaundice subsided, liver function improved, to restore the oral diet. One case had incision infection after operation without any other complications. Conclusions Laparoscopic choledochojejunostomy combined with ENBD palliative treatment of advanced pancreatic cancer is feasible and effective, with less trauma, complete yellowing, less pain after operation, shorter hospitalization time and so on.