Huang Y T, Xing M R
First Hospital, Beijing Medical University.
Zhonghua Wai Ke Za Zhi. 1994 Oct;32(10):603-5.
6 cases of local resection for the treatment of carcinoma of the papilla of Vater were reported. The average age was 63.8 years. All the patients were admitted with chief complaint of jaundice. The ill course was 1-2 months. The diagnosis was confirmed in 2 cases through endoscopic biopsy and in 4 by frozen section during surgery. The tumors were visualized with the diameter less than 2 cm. The survival time was related with pathological condition of the tumor. 1 of low differentiated and 1 of infiltrative adenocarcinoma were died of 16 and 20 months respectively after surgery. In 2 papillocarcinoma, 1 survived more than 5 years, another died of other cause after 28 months postoperatively. 1 of high differentiated carcinoma and 1 of mucinous carcinoma survived well after 29 and 46 months respectively. Local resection is not a real radical operation. It is only indicated for old patients with high-risk or severe concurrent diseases. They are not able to tolerated whipple procedure and tumors are small enough to be excised locally. A better survival rate would be expected. The operative technique was discussed in detail.
报告了6例采用局部切除术治疗 Vater 壶腹癌的病例。平均年龄为63.8岁。所有患者均以黄疸为主诉入院。病程为1 - 2个月。2例通过内镜活检确诊，4例在手术中通过冰冻切片确诊。肿瘤直径小于2 cm。生存时间与肿瘤的病理状况有关。1例低分化浸润性腺癌患者分别在术后16个月和20个月死亡。2例乳头状癌患者中，1例存活超过5年，另1例在术后28个月死于其他原因。1例高分化癌和1例黏液癌患者分别在术后29个月和46个月存活良好。局部切除术并非真正的根治性手术。它仅适用于具有高风险或严重合并症的老年患者。他们无法耐受惠普尔手术，且肿瘤小到足以进行局部切除。预期会有较好的生存率。详细讨论了手术技术。
