[手术切除壶腹在良性壶腹肿瘤治疗中的价值]
[Value of surgical ampullectomy in the management of benign ampullary tumors].
作者信息
Sa Cunha A, Larroudé D, Laurent C, Rault A, Collet D, Masson B
机构信息
Service de chirurgie digestive et endocrinienne, hôpital Haut-l'Evêque, avenue de Magellan, 33604 Pessac, France.
出版信息
Ann Chir. 2005 Jan;130(1):32-6. doi: 10.1016/j.anchir.2004.11.006.
AIM OF THE STUDY
To report the results of transduodenal excision (TDE) for tumors of the ampulla of Vater.
PATIENTS AND METHODS
From 1998 to 2003, 10 patients underwent a transduodenal excision for presumed benign tumors of the ampulla of Vater. After resection, frozen sections were performed to ensure negative margins.
RESULTS
There was no operative mortality. A postoperative pancreatitis occurred in one patient. For nine patients the postoperative course was uneventful. The mean duration of hospital stay was 18 +/-11 days. The final pathology showed adenoma in 8 patients, an adenocarcinoma in one patient and inflammatory lesions in other one. With a mean follow-up of 20 months, endoscopy did not show any recurrence in patients with benign lesion. Patient with an invasive cancer developed recurrence.
CONCLUSION
Transduodenal excision is safe and effective treatment for benign ampullary tumors. TDE should be the operation of choice for patients with histologically-proven benign ampulloma, staged as uT1 by endoscopic ultrasound. This approach could reduce the rate of pancreaticaduodenoctomy performed for benign ampullomas.
研究目的
报告经十二指肠切除术（TDE）治疗 Vater 壶腹肿瘤的结果。
患者与方法
1998 年至 2003 年，10 例患者因疑似 Vater 壶腹良性肿瘤接受了经十二指肠切除术。切除后，进行冰冻切片检查以确保切缘阴性。
结果
无手术死亡病例。1 例患者发生术后胰腺炎。9 例患者术后病程平稳。平均住院时间为 18±11 天。最终病理显示 8 例为腺瘤，1 例为腺癌，另 1 例为炎性病变。平均随访 20 个月，良性病变患者的内镜检查未显示任何复发。浸润性癌患者出现复发。
结论
经十二指肠切除术是治疗良性壶腹肿瘤的安全有效方法。对于经组织学证实为良性壶腹瘤且经内镜超声分期为 uT1 的患者，TDE 应作为首选手术方式。这种方法可降低因良性壶腹瘤而行胰十二指肠切除术的比例。
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