胆总管十二指肠桥式内引流术在中晚期胰腺癌中的临床应用价值.docVIP

精品论文 参考文献 胆总管十二指肠桥式内引流术在中晚期胰腺癌中的临床应用价值 高利雄（四川省邛崃市医疗中心医院普外科 四川邛崃 611530） 【中图分类号】R736.7【文献标识码】A【文章编号】1672-5085（2011）45-0083-02 【摘要】 目的 通过胆总管十二指肠桥式内引流术迅速改善由胆道梗阻给患者造成的胆道、消化道以及心理的一系列不适，从而探讨该术式的临床应用价值。方法 回顾性分析1999年1月至2008年1月我院收治的31例中晚期胰腺癌患者，在采用多种不同术式后，其临床结果的比较。其中2例较晚，无法入腹，放弃手术；5例仅能作胆囊造漏；2例可作T管胆道外引流术；1例可作胆囊空肠吻合术；8例作传统胰十二指肠切除术；13例作胆总管十二指肠桥式内引流术。结果 2例无法入腹的患者在术后不到2周内死亡；5例仅能作胆囊造漏，2例可作T管胆道处引流术和1例作胆囊空肠肠合术的患者，不到半年均死亡；8例作传统胰十二指肠切除术的患者，2例死于术后并发流，其余6例不到1年均死亡；13例作胆总管十二指肠桥式内引流术的患者，其中6例均活到接近2年，4例均活到接近1年，3例均活到半年以上。结论 在中晚期胰腺癌的患者中，传统的多种手术后，大多数患者在半年内死亡。相较于其它传统手术，胆总管十二指肠桥式内引流术，对患者损伤小，恢复快，花费少，平均住院日短，可极大改善和提高该类患者中晚期的生活质量，节约社会资源，降低社会成本，取得了极好的社会和经济效益，值得推广。 【关键词】胆总管 十二指肠 桥式内引流术 中晚期胰腺癌 【Abstract】Objective To bridge internal drainage of common bile duct duodenum by the rapid improvement in patients with biliary obstruction due to biliary, gastrointestinal, and a series of psychological discomfort, so as to explore the clinical value of surgical procedures. Methods A retrospective analysis from January 1999 to January 2008 in our hospital 31 patients with advanced pancreatic cancer patients, using a variety of different operations in the rear, the clinical results of the comparison. 2 cases of late, not Rufu, to give up surgery; five cases of gallbladder can only be made for leakage; two cases can be used outside the T-tube biliary drainage; one case can be used for gallbladder anastomosis; eight cases for conventional pancreatic duodenal bowel resection; 13 cases for the common bile duct duodenal bridge internal drainage. Result The results of two cases of patients unable to Rufu less than 2 weeks after death; five cases of gallbladder can only be made leak, two cases can be used at the T-tube biliary drainage for gallbladder surgery and one case of jejunal intestinal co-surgery patients, not to six months, all died; eight cases for traditional pancreaticoduodenectomy patients, 2 patients died of postoperative flow, the remaining 6 patients died less than average; 13 cases for the com