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自1935年whipple对十二指肠乳头癌减黄后行胰头十二指肠切除术(PD)以来,PD一直是治疗壶腹周围癌的经典术式。目前主要采用whipple、child法重建消化道,二者都将胃肠吻合口放在胰肠、胆畅吻台口之下,以便胃肠道内酸碱中和,减少吻合口溃疡的发生。且手术的根本问题是提高手术切除率、降低死亡率、提高5年生存率。作者收集本院1993～1995年中3例PD,时如何提高胰头癌或壶腹部周围癌切除率、术中估价、手术技术等问题加以探讨。
Since 1935, whipple has performed pancreaticoduodenectomy (PD) for the reduction of duodenal papillary carcinoma, PD has been the classic procedure for the treatment of periampullary cancer. At present, the whipple, child method is mainly used to reconstruct the digestive tract, both of which place the gastroenteric anastomosis on the pancreatic intestine and the gallbladder and kiss the mouth under the mouth to facilitate acid-base neutralization in the gastrointestinal tract and reduce the occurrence of anastomotic ulcer. The fundamental problem of surgery is to increase the surgical resection rate, reduce the mortality, and increase the 5-year survival rate. The authors collected three cases of PD in our hospital from 1993 to 1995 and discussed how to improve the rate of resection of pancreatic cancer or periampullary cancer, intraoperative assessment, and surgical techniques.