肝胰十二指肠切除术治疗胆管癌和胆囊癌的安全性与疗效的系统评价
A systematic review of safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.
作者信息
Zhou Yanming, Zhang Zuobing, Wu Lupeng, Li Bin
机构信息
Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen 361003, China.
Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, 55 Zhenhai Road, Xiamen 361003, China.
出版信息
HPB (Oxford). 2016 Jan;18(1):1-6. doi: 10.1016/j.hpb.2015.07.008. Epub 2015 Nov 30.
OBJECTIVES
To review the evidence on the safety and efficacy of hepatopancreatoduodenectomy for biliary and gallbladder cancers.
METHODS
Medline and EMBASE were systematically searched for papers of hepatopancreatoduodenectomy in patients with biliary and gallbladder cancers.
RESULTS
Eighteen studies involving 397 patients were reviewed. Major hepatectomy was undertaken in 81.3% of the 397 patients and the R0 resection rate was 71.3%. The morbidity and mortality rates were 78.9% and 10.3%, respectively. The 5-year overall survival rate ranged from 3% to 50% (median = 31%). The 5-year survival rate in patients who underwent curative resection was 18-68.8% (median = 51.3%), and 0% in patients who received non-curative resection.
CONCLUSIONS
Hepatopancreatoduodenectomy is a challenging procedure with high morbidity and mortality rates. However, this procedure can provide a chance of long-term survival in patients in whom curative resection is feasible.
目的
回顾关于肝胰十二指肠切除术治疗胆管癌和胆囊癌的安全性及疗效的证据。
方法
系统检索Medline和EMBASE数据库，查找有关胆管癌和胆囊癌患者行肝胰十二指肠切除术的文献。
结果
共回顾了18项研究，涉及397例患者。397例患者中81.3%接受了肝大部切除术，R0切除率为71.3%。发病率和死亡率分别为78.9%和10.3%。5年总生存率为3%至50%（中位数 = 31%）。接受根治性切除患者的5年生存率为18% - 68.8%（中位数 = 51.3%），接受非根治性切除患者的5年生存率为0%。
结论
肝胰十二指肠切除术是一项具有挑战性的手术，发病率和死亡率较高。然而，对于可行根治性切除的患者，该手术可提供长期生存的机会。
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