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目的 探讨胃癌侵犯胰腺的手术治疗价值。方法 对 3 90例胃癌术前行电子胃镜 ,上腹B超 ,螺旋CT扫描 ,所有病例均接受外科手术 ,术中及术后病理证实胃癌侵犯胰腺 60例。术中行联合胰腺切除的胃癌根治术 3 3例 ,非根治术 2 7例。结果 CT扫描和B超提示侵犯胰腺术前诊断率分别为 72 .41%和 3 8.3 3 %。联合胰腺切除的根治手术和非根治术两组的生存期差异有显著性 ( P <0 .0 5 )。结论 CT扫描和上腹部超声对胃癌侵犯胰腺诊断有较大帮助。联合胰腺切除的胃癌根治术可延长部分病例生存期。胰腺受侵犯未作胰腺部分切除者效果差。
Objective To investigate the surgical treatment of gastric cancer invading the pancreas. Methods Three hundred and ninety cases of gastric cancer underwent gastroscopic endoscopy, abdominal ultrasonography and spiral CT scan. All the cases were undergone surgery. Intraoperative and postoperative pathology confirmed 60 cases of gastric cancer invading the pancreas. In the operation, 33 cases of radical resection of gastric cancer combined with pancreatectomy and 27 cases of non-radical operation. Results The preoperative diagnosis rates of CT scan and B-scan in patients with pancreatic invasion were 72.41% and 8.33% respectively. There was a significant difference in survival between the radical resection and non-radical resection of pancreas (P <0.05). Conclusion CT scan and upper abdominal ultrasound are helpful to the diagnosis of gastric cancer invading the pancreas. Radical gastrectomy combined with pancreatectomy may prolong the survival of some cases. Pancreatic invasion is not as part of the resection of the pancreas poor results.