Sørensen M B, Lundemose J B, Rokkjaer M, Jacobsen N O
Dept. of Surgery L and Institute of Pathology, Aarhus University Hospital, Aarhus Kommunehospital, Denmark.
Scand J Gastroenterol. 1998 Jul;33(7):759-64. doi: 10.1080/00365529850171729.
In this retrospective review short- and long-term perspectives have been evaluated for 108 patients who, during 1982 through 1992, had Whipple's operation performed for carcinoma of the pancreatic head (PC, n=63) or the ampullary region (AC, n=45). In 24 patients the operation was not radical (21 with PC and 3 with AC).
Total perioperative morbidity was 60%, and 13 patients (12%) died within 30 days of operation. This decreased from 15.2% in the first half of the study period to 8.2% in the second half. Recurrence occurred in 56.2% of the remaining 73 patients, with no significant differences between PC and AC. Recurrence was related to regional lymph node metastases and poor tumour differentiation. Overall 5-year survival was 7.4% for PC and 24.8% for AC. For patients with radically excised tumours surviving 30 days the 5-year survival rates were 13.1% for PC and 30% for AC.
Careful preoperative evaluation is still of great importance.
在这项回顾性研究中，对1982年至1992年间因胰头癌（PC，n = 63）或壶腹周围区域癌（AC，n = 45）接受惠普尔手术的108例患者的短期和长期情况进行了评估。24例患者的手术不彻底（21例为PC，3例为AC）。
围手术期总发病率为60%，13例患者（12%）在术后30天内死亡。这一比例从研究期前半段的15.2%降至后半段的8.2%。其余73例患者中有56.2%出现复发，PC和AC之间无显著差异。复发与区域淋巴结转移和肿瘤分化差有关。总体而言，PC患者的5年生存率为7.4%，AC患者为24.8%。对于术后存活30天的根治性切除肿瘤患者，PC的5年生存率为13.1%，AC为30%。
仔细的术前评估仍然非常重要。
