[壶腹肿瘤的外科治疗经验]

[Experience with the surgical management of Vater's ampulla tumors].

作者信息

Belágyi T, Nagy S A, Pardavi G, Oláh A

机构信息

Petz Aladár Megyei Oktató Kórház, Sebészeti Osztály.

出版信息

Magy Seb. 2001 Feb;54(1):27-31.

PMID:11299861

Abstract

The article reviews our experience about tumours of the papilla of Vater. 30 patients were operated on between 1996-1999. The mean age was 58 years, the leading symptom (73%) was jaundice. In 23 patients preoperative ERCP was successful and was completed in 15 cases with EST, in 8 cases with biliary drainage. In 3 patients--despite benign endoscopic histology--intraoperative frozen section, and in one patient final histology confirmed malignancy. Altogether in 27 patients was malignant transformation of the papilla observed. In 15 cases pylorus-preserving pancreatoduodenectomy (PPPD), in 2 cases local excision (LE), while in 10 patients palliative procedures were performed. Resection rate (PPPD + LE) was 63%, while radical resection (PPPD) was performed in 55.5% of all cases. During 26 months mean follow-up survival rate was altogether 74%, and 80% in radically resected patients. We review the literature, describe the difficulty of histological and describe our experience and practice in the treatment of this rare tumour.

摘要

本文回顾了我们关于 Vater 壶腹肿瘤的经验。1996 年至 1999 年期间，对 30 例患者进行了手术。平均年龄为 58 岁，主要症状（73%）为黄疸。23 例患者术前 ERCP 成功，其中 15 例完成 EST，8 例进行胆管引流。3 例患者——尽管内镜组织学检查为良性——术中冰冻切片检查，1 例患者最终组织学检查确诊为恶性。总共观察到 27 例乳头恶性转化。15 例患者行保留幽门胰十二指肠切除术（PPPD），2 例患者行局部切除术（LE），10 例患者行姑息性手术。切除率（PPPD + LE）为 63%，而根治性切除（PPPD）在所有病例中的比例为 55.5%。在平均 26 个月的随访期间，总体生存率为 74%，根治性切除患者的生存率为 80%。我们回顾了文献，描述了组织学诊断的困难，并阐述了我们在治疗这种罕见肿瘤方面的经验和做法。