Lorenzini L, Lorenzi M
Minerva Chir. 1978 Sep 15;33(17):989-95.
Personal experience acquired in the use of radical and palliative techniques in the treatment of 18 cases of carcinoma of the pancreas and 1 of carcinoma of the ampulla hepatopancreatica is reported. The results show that duodenocephalo-pancreasectomy is a sound procedure, particularly in the absence of lymph node invasion. Operative mortality is low if the surgeon is experienced. In the even of serious and prolonged cholostasis, the operation can be preceded by a biliary shunt. According to the Authors there are not yet valid reasons as to the survival to prefer total pancreasectomy instead the partial pancreasectomy because of the high mortality of the former. Early diagnosis and the recognition of precancerous conditions still represent determining factors as far as operability and hence survival are concerned. The efficacy of chemotherapy is uncertain at present.
报告了在治疗18例胰腺癌和1例壶腹周围癌时采用根治性和姑息性技术所获得的个人经验。结果表明,十二指肠胰头切除术是一种可靠的手术方法,尤其是在无淋巴结侵犯的情况下。如果外科医生经验丰富,手术死亡率较低。在严重且长期胆汁淤积的情况下,可在手术前先行胆分流术。作者认为,由于全胰切除术死亡率高,目前尚无充分理由选择全胰切除术而非部分胰切除术来提高生存率。就可手术性及生存率而言,早期诊断和癌前病变的识别仍是决定性因素。目前化疗的疗效尚不确定。