不能切除的老年胰頭癌患者行不同減黃方式的對比研究_《中國普外基礎與臨床雜志》

作者：

蔣曉忠 , 趙少勇 , 羅洪 , 王昌松 , 黃斌 , 朱勇 , 龔光 , 周文浩 , 陶友江

宜賓市第二人民醫院肝膽胰外科（四川宜賓 644000）;

關鍵詞：

腫瘤老年患者姑息性手術胰頭癌生存質量

視頻：

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目的探討對于不能切除的胰頭癌老年患者行外科手術減黃的安全性和有效性。
方法回顧性分析2002年7月至2009年6月期間在我科因患有不能切除的胰頭癌而行姑息性治療的55例患者的臨床資料，根據不同年齡和治療方法患者分為以下3組: A組（年齡≥65歲，n=19），行外科手術轉流膽汁減黃； B組（年齡 lt;65歲，n=19），行外科手術轉流膽汁減黃； C組（年齡≥65歲，n=17），僅接受PTBD減黃，對各組患者治療結果進行分析。
結果 A組患者與B組比較，術后血膽紅素水平、早期并發癥發生率、術后平均住院時間及平均生存時間的差異均無統計學意義（P gt;0.05），但B組中1例（5.3%）患者出現黃疸復發，1例（5.3%）患者出現胃輸出梗阻，而A組則沒有，差異有統計學意義（P lt;0.01）。與A組比較，C組患者術后血膽紅素水平、再入院例數、黃疸復發率以及胃輸出梗阻發生率更高（P lt;0.05和P lt;0.01）。C組患者的術后平均住院時間和平均生存期均短于A組（P lt;0.01和P lt;0.05）。
結論對于患有不能切除的胰頭癌老年患者，外科手術減黃不會增加并發癥發生率，并可以提高其生存質量。

引用本文： 蔣曉忠,趙少勇,羅洪,王昌松,黃斌,朱勇,龔光,周文浩,陶友江. 不能切除的老年胰頭癌患者行不同減黃方式的對比研究. 中國普外基礎與臨床雜志, 2010, 17(8): 837-840. doi: 復制

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2.	Singh SM, Longmire WP Jr, Reber HA. Surgical palliation for pancreatic cancer. The UCLA experience [J]. Ann Surg, 1990; 212(2): 132139.
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6.	孫備, 陳華. 胰腺癌外科治療的現狀與展望 [J]. 中國普外基礎與臨床雜志, 2008; 15(8): 547549.
7.	Cameron JL, Riall TS, Coleman J, et al. One thousand consecutive pancreaticoduodenectomies [J]. Ann Surg, 2006; 244(1): 1015.
8.	Richter A, Niedergethmann M, Sturm JW, et al. Longterm results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25year experience [J]. World J Surg, 2003; 27(3): 324329.
9.	CarpelanHolmstrm M, Nordling S, Pukkala E, et al. Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study reevaluating the data of the Finnish Cancer Registry [J]. Gut, 2005; 54(3): 385387.
10.	Winter JM, Cameron JL, Campbell KA, et al. 1 423 pancreaticoduodenectomies for pancreatic cancer: A singleinstitution experience [J]. J Gastrointest Surg, 2006; 10(9): 11991211.
11.	Loos M, Kleeff J, Friess H, et al. Surgical treatment of pancreatic cancer [J]. Ann N Y Acad Sci, 2008; 1138: 169180.
12.	趙玉沛, 張太平. 重視交界性可切除胰腺癌的處理 [J]. 中國普外基礎與臨床雜志, 2009; 16(8): 597600.
13.	Petrowsky H, Clavien PA. Should we deny surgery for malignant hepatopancreaticobiliary tumors to elderly patients? [J]. World J Surg, 2005; 29(9): 10931100.
14.	Urbach DR, Bell CM, Swanstrom LL, et al. Cohort study of surgical bypass to the gallbladder or bile duct for the palliation of jaundice due to pancreatic cancer [J]. Ann Surg, 2003; 237(1): 8693.
15.	Taylor MC, McLeod RS, Langer B. Biliary stenting versus bypass surgery for the palliation of malignant distal bile duct obstruction: a metaanalysis [J]. Liver Transpl, 2000; 6(3): 302308.
16.	Nuzzo G, Clemente G, Greco F, et al. Is the chronologic age a contraindication for surgical palliation of unresectable periampullary neoplasms? [J]. J Surg Oncol, 2004; 88(4): 206209.
17.	Lesurtel M, Dehni N, Tiret E, et al. Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal [J]. J Gastrointest Surg, 2006; 10(2): 286291.

1. Casadei R, Zanini N, MorselliLabate AM, et al. Prognostic factors in periampullary and pancreatic tumor resection in elderly patients [J]. World J Surg, 2006; 30(11): 19922003.
2. Singh SM, Longmire WP Jr, Reber HA. Surgical palliation for pancreatic cancer. The UCLA experience [J]. Ann Surg, 1990; 212(2): 132139.
3. Gouma DJ, van Geenen R, van Gulik T, et al. Surgical palliative treatment in biliopancreatic malignancy [J]. Ann Oncol, 1999; 10 Suppl 4: 269272.
4. 倪泉興, 楊峰. 規范診治，努力提高胰腺癌的遠期生存率 [J]. 中國普外基礎與臨床雜志, 2006; 13(5): 493495.
5. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008 [J]. CA Cancer J Clin, 2008; 58(2): 7196.
6. 孫備, 陳華. 胰腺癌外科治療的現狀與展望 [J]. 中國普外基礎與臨床雜志, 2008; 15(8): 547549.
7. Cameron JL, Riall TS, Coleman J, et al. One thousand consecutive pancreaticoduodenectomies [J]. Ann Surg, 2006; 244(1): 1015.
8. Richter A, Niedergethmann M, Sturm JW, et al. Longterm results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25year experience [J]. World J Surg, 2003; 27(3): 324329.
9. CarpelanHolmstrm M, Nordling S, Pukkala E, et al. Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study reevaluating the data of the Finnish Cancer Registry [J]. Gut, 2005; 54(3): 385387.
10. Winter JM, Cameron JL, Campbell KA, et al. 1 423 pancreaticoduodenectomies for pancreatic cancer: A singleinstitution experience [J]. J Gastrointest Surg, 2006; 10(9): 11991211.
11. Loos M, Kleeff J, Friess H, et al. Surgical treatment of pancreatic cancer [J]. Ann N Y Acad Sci, 2008; 1138: 169180.
12. 趙玉沛, 張太平. 重視交界性可切除胰腺癌的處理 [J]. 中國普外基礎與臨床雜志, 2009; 16(8): 597600.
13. Petrowsky H, Clavien PA. Should we deny surgery for malignant hepatopancreaticobiliary tumors to elderly patients? [J]. World J Surg, 2005; 29(9): 10931100.
14. Urbach DR, Bell CM, Swanstrom LL, et al. Cohort study of surgical bypass to the gallbladder or bile duct for the palliation of jaundice due to pancreatic cancer [J]. Ann Surg, 2003; 237(1): 8693.
15. Taylor MC, McLeod RS, Langer B. Biliary stenting versus bypass surgery for the palliation of malignant distal bile duct obstruction: a metaanalysis [J]. Liver Transpl, 2000; 6(3): 302308.
16. Nuzzo G, Clemente G, Greco F, et al. Is the chronologic age a contraindication for surgical palliation of unresectable periampullary neoplasms? [J]. J Surg Oncol, 2004; 88(4): 206209.
17. Lesurtel M, Dehni N, Tiret E, et al. Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal [J]. J Gastrointest Surg, 2006; 10(2): 286291.

《中國普外基礎與臨床雜志》

不能切除的老年胰頭癌患者行不同減黃方式的對比研究

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《中國普外基礎與臨床雜志》

不能切除的老年胰頭癌患者行不同減黃方式的對比研究

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料