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过去40年根治性胰十二指肠切除(即Whipple手术,下称W术)被视为治疗胰腺癌的标准外科手术。但此手术的5年生存率仅18％或更低,且常伴有胃切除术后综合征及其所致的营养障碍。近年来不少作者推荐保留幽门部、胃及近端1～2cm十二指肠的胰十二指肠切除术(下称改良W术),以期降低胃切除术后的并发症面不影响肿瘤整块切除的原则。一些研究认为可切除胰癌很少向幽门区和胃窦部播散,面术后生存率与标准W术相比并无差异,从而鼓午人们以改良W术作为治疗胰癌的定形手术。
A radical pancreatoduodenectomy (ie, Whipple surgery, hereinafter referred to as W surgery) over the past 40 years has been considered as a standard surgical procedure for the treatment of pancreatic cancer. However, the 5-year survival rate of this operation is only 18% or less, and it is often accompanied by post-gastrectomy syndrome and its resulting dystrophy. In recent years, many authors recommend retaining the pancreaticoduodenectomy of the pylorus, stomach and proximal 1~2cm duodenum (hereinafter referred to as modified W surgery) in order to reduce the complications after gastrectomy without affecting the tumor. The principle of whole block removal. Some studies suggest that resectable pancreatic cancer rarely spreads to the pylorus and antrum, and there is no difference in the postoperative survival rate compared with standard W-surgery. Thus, the midwife uses modified W as a treatment for pancreatic cancer.