动脉先行路径胰十二指肠切除术联合血管切除治疗复杂胰头肿瘤的疗效

摘要

目的 探讨动脉先行路径胰十二指肠切除术联合血管切除治疗复杂胰头肿瘤的效果.方法 回顾性分析37例胰头癌患者的临床资料,其中17例行动脉先行路径胰十二指肠切除术,20例行标准路径术式.比较2组患者一般临床资料、手术情况、住院时间、术后并发症、切缘阳性率、术后生存时间等指标.结果 2组患者在住院时间、术后并发症等方面无显著差异.动脉先行组的手术时间、术中出血量等方面较标准手术组低(P<0.05),同时R1切除率低(P=0.032),术后生存时间(P=0.025)和无进展生存时间更长(P=0.025).结论 动脉先行路径胰十二指肠切除处理联合血管切除治疗复杂胰头肿瘤安全有效.%Objective To investigate the clinical effect of artery first approach pancreaticoduodenectomy(AFA PD)combined with vasculaRresection on treatment of patients with complex pancreatic head cancer.Methods Clinical materials of 37 patients with pancreatic head canceRwere analyzed retrospectively,in which 17 patients was treated with AFA PD and 20 patients was treated with standard PD.The general clinical data,operation time,hospital stay,postoperative complications,positive margins,and postoperative survival time were observed.Results There were no significant differences in the length of hospitalization and complications between two groups.Intra-operative blood loss and operation time was significantly loweRin AFA PD group than SPD group(P<0.05).In the AFA PD group,rate of R1 resection,postoperative survival time and progression free survival time were betteRthan SPD group (P=0.025).Conclusion Artery first approach pancreaticoduodenectomy combined with vasculaRresection is safe and effective in treatment of patients with pancreatic head cancer.