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对62例胰、十二指肠切除术者,术中不同方法诊断可切除胰头、壶腹部癌的有效性进行了回顾。胰周淋巴结活检的阳性率为20%,诊断有效性最低。细针穿刺抽吸活检(FNAB)诊断胰头癌的阳性率为71.43%,而胰切取活检阳性率仅为40%。两者比较,FNAB诊断胰腺癌更有意义。经十二指肠切开活检,结合胆总管刮取活检常能使壶腹部癌的诊断获得满意结果。临床诊断应主要用于术中怀疑胰腺癌,而获得其组织学诊断又有一定困难的病人。文中对避免临床判断失误的要点进行了讨论。
For 62 pancreatic and duodenal resection patients, the effectiveness of different methods in the diagnosis of resectable pancreatic head and ampulla cancer was reviewed. The positive rate of peripancreatic lymph node biopsy was 20%, with the lowest diagnostic effectiveness. The positive rate of fine needle aspiration biopsy (FNAB) in the diagnosis of pancreatic head cancer was 71.43%, while the positive rate of pancreatic cancer biopsy was only 40%. Comparing the two, FNAB is more meaningful in the diagnosis of pancreatic cancer. The duodenal biopsy, combined with common bile duct scraping biopsy, often results in a satisfactory diagnosis of ampulla cancer. Clinical diagnosis should be used primarily for patients who suspect pancreatic cancer during surgery and have certain difficulties in histological diagnosis. The article discusses the points of avoiding clinical misjudgments.