Takada T
First Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan.
Hepatogastroenterology. 1993 Oct;40(5):422-5.
Pylorus-preserving pancreatoduodenectomy is accepted as definitive treatment of some malignancies, such as cancer of the duodenal papilla, and cancer of the lower bile duct. However, its use in cancer of the head of the pancreas is controversial. We have applied pylorus-preserving pancreatoduodenectomy combined with extended lymph node dissection as the major technique in cases of malignant disease. Also, when invasion of the portal vein is confirmed or suspected, portal vein resection has been combined. However, when the duodenal bulb or pyloric ring has been invaded by cancer, the classic Whipple operation has been indicated. Our experience over the last 11 years has demonstrated no statistical difference in the 5-year survival rate between patients with pancreatic head cancer treated with the Whipple procedure (n = 25, 34.8%) and pylorus-preserving pancreatoduodenectomy (n = 16, 33.3%). Also, the postoperative quality of life proved to be better in patients with pylorus-preserving pancreatoduodenectomy. These data support the continued application of pylorus-preserving pancreatoduodenectomy for the treatment of cancer of the head of the pancreas.
保留幽门的胰十二指肠切除术被公认为是十二指肠乳头癌和低位胆管癌等某些恶性肿瘤的确定性治疗方法。然而，其在胰头癌治疗中的应用存在争议。我们已将保留幽门的胰十二指肠切除术联合扩大淋巴结清扫作为恶性疾病病例的主要技术。此外，当确认或怀疑门静脉受侵时，已联合进行门静脉切除。然而，当十二指肠球部或幽门环受癌侵犯时，则采用经典的惠普尔手术。我们过去11年的经验表明，接受惠普尔手术（n = 25，34.8%）和保留幽门的胰十二指肠切除术（n = 16，33.3%）治疗的胰头癌患者的5年生存率无统计学差异。此外，保留幽门的胰十二指肠切除术患者的术后生活质量更好。这些数据支持继续应用保留幽门的胰十二指肠切除术治疗胰头癌。
