Schütz G, Aleksic M, Ulrich B
Chirurgische Klinik, Kliniken der Landeshaupstadt Düsseldorf, Krankenhaus Gerresheim, Germany.
Int J Surg Investig. 2000;1(6):525-9.
The aim of this study is to evaluate the role of surgery in the treatment of duodenal cancer.
From October 1987 to January 1999, 7 patients (3 female/4 male) with primary non-ampullary duodenal adenocarcinoma underwent surgical treatment in our department. Presenting signs and symptoms were abdominal pain, weight loss, anaemia and obstruction. Upper gastrointestinal contrast study, computed tomography (CT) and duodenoscopy were the primary diagnostic procedure modalities. All diagnoses were confirmed histologically. Five of 7 patients were resectable for cure at the time of their first surgical intervention.
In 5 patients, the tumour could be removed with tumour-free margins. One patient, where the histopathological workup revealed tumour cells in the resection margins, died 29 months after the surgical intervention. In another patient, complete tumour resection could not be achieved. Subsequently, postoperative survival was only 2 months. Operative mortality was 0%. Patients with R0-status showed a postoperative survival of at least 24 months.
In the management of resectable non-ampullary malignancies of the duodenum, surgical radicality including lymphadenectomy should be pursued. The radical operative treatment with lymphadenectomy offers a reasonable chance for cure in some patients.
本研究旨在评估手术在十二指肠癌治疗中的作用。
1987年10月至1999年1月，7例原发性非壶腹十二指肠腺癌患者（3例女性/4例男性）在我科接受了手术治疗。主要症状和体征为腹痛、体重减轻、贫血和梗阻。上消化道造影、计算机断层扫描（CT）和十二指肠镜检查是主要的诊断方法。所有诊断均经组织学证实。7例患者中有5例在首次手术干预时可切除以治愈。
5例患者的肿瘤可切除且切缘无肿瘤细胞。1例患者组织病理学检查显示切缘有肿瘤细胞，术后29个月死亡。另1例患者未能实现肿瘤完全切除。随后，术后生存期仅2个月。手术死亡率为0%。R0状态的患者术后生存期至少为24个月。
在可切除的非壶腹十二指肠恶性肿瘤的治疗中，应追求包括淋巴结清扫在内的手术根治性。行淋巴结清扫的根治性手术治疗为部分患者提供了合理的治愈机会。
