Cameron J L
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Annu Rev Med. 1995;46:361-70. doi: 10.1146/annurev.med.46.1.361.
Carcinoma of the head of the pancreas can be diagnosed and staged effectively by computed tomography (CT) scan and by visceral angiography. If the tumor appears to be resectable, no further studies such as percutaneous biopsy are required. Pancreaticoduodenectomy is the only potentially curable treatment. This operation can be performed with a hospital mortality rate of approximately 2%. If the resection is curative, five-year survival in excess of 20% can be anticipated. Utilizing multivariate analysis, negative lymph node status, the absence of microscopic evidence of blood vessel involvement, and two or fewer blood transfusions during surgery are all independent predictors of long-term survival. Adjuvant therapy is effective and should be used routinely.
胰腺头部癌可通过计算机断层扫描（CT）和内脏血管造影有效地进行诊断和分期。如果肿瘤看起来可切除，则无需进行诸如经皮活检等进一步检查。胰十二指肠切除术是唯一可能治愈的治疗方法。该手术的医院死亡率约为2%。如果切除是根治性的，则可预期五年生存率超过20%。利用多变量分析，阴性淋巴结状态、无微血管侵犯的微观证据以及手术期间输血两次或更少均是长期生存的独立预测因素。辅助治疗有效，应常规使用。
