Lagoudianakis E E, Tsekouras D, Koronakis N, Chrysicos J, Archontovasilis F, Filis K, Katergiannakis V, Manouras A
First Department of Propaedeutic Surgery, "Hippocrateion" Hospital, Athens Medical School, Athens, Greece.
J BUON. 2008 Oct-Dec;13(4):569-72.
Local surgical treatment of periampullary neoplasms seems attractive in the context of the reduced morbidity and mortality than the more radical treatment options. The aim of our study was to compare local excision (LE) of the ampulla with standard pancreaticoduodenectomy (PD) for the treatment of periampullary cancer in terms of overall survival. Inclusion criteria were primary tumor < or = 2 cm with no evidence of lymph node involvement or distant metastasis on abdominal computed tomography (CT). Between January 2000 and January 2004, 23 patients were enrolled onto this study (9 in the LE group and 14 in the standard PD group). The two groups were homogeneous with respect to age and gender as well as the size and origin of the primary neoplasm. There was no correlation of the survival with age, gender, presence of lymph node metastasis, size of the primary tumor, type of surgery or histologic grade (x(2), p >0.05). However, the origin of the tumor had major impact on survival, with pancreatic tumors having the worst prognosis. Hospital stay was significantly reduced in the LE treated patients. Our results showed that LE for periampullary tumors is a viable option and is well suited for medically unfit patients or those who refuse more radical treatment options.
与更激进的治疗方案相比，壶腹周围肿瘤的局部手术治疗因其较低的发病率和死亡率而颇具吸引力。我们研究的目的是比较壶腹局部切除术（LE）与标准胰十二指肠切除术（PD）治疗壶腹周围癌的总生存率。纳入标准为原发性肿瘤≤2 cm，腹部计算机断层扫描（CT）未发现淋巴结受累或远处转移。2000年1月至2004年1月，23例患者纳入本研究（LE组9例，标准PD组14例）。两组在年龄、性别以及原发性肿瘤的大小和起源方面具有同质性。生存率与年龄、性别、淋巴结转移情况、原发性肿瘤大小、手术类型或组织学分级均无相关性（χ²，p>0.05）。然而，肿瘤的起源对生存率有重大影响，胰腺肿瘤的预后最差。LE治疗的患者住院时间显著缩短。我们的结果表明，壶腹周围肿瘤的LE是一种可行的选择，非常适合身体状况不佳或拒绝更激进治疗方案的患者。
