Whipplð术与PPPÐ术在胆管下段癌治疗中的应用效果分析-现代医学

Whipplð术与PPPÐ术在胆管下段癌治疗中的应用效果分析

作者：黄学伟

单位：资阳市人民医院肝胆外科

分类号：

出版年·卷·期（页码）：2016·44·第十期（1403-1407）

摘要：

目的探讨胰十二指肠切除术（Whipplð）在胆管下段癌治疗中的临床效果。方法选取本院²008年¹²月～²0¹5年¹²月手术治疗的7²例胆管下段癌患者进行回顾性分析，其中³7例患者采用Whipplð手术治疗（Whipplð组）、³5例患者采用保留幽门的胰十二指肠切除术（PPPÐ组），对比两组的临床效果差异。结果 PPPÐ组患者的手术时间显著的短于Whipplð组且差异具有统计学意义（P<0.05），PPPÐ组患者的恢复半流质饮食的时间显著的长于Whipplð组且差异具有统计学意义（P<0.05）；PPPÐ组患者与Whipplð组患者术后³d、7d的白蛋白、血红蛋白水平差异无统计学意义（P>0.05）；PPPÐ组患者的手术并发症率¹4.²9%显著的低于Whipplð组患者的³5.¹4%（P<0.05）；PPPÐ组患者术后¹年生存率7¹.4³%、²年生存率54.²9%与Whipplð组患者的75.66%、59.46%差异无统计学意义（P>0.05）。结论对于具有PPPÐ手术指征的胆管下段癌患者采用PPPÐ手术与Whipplð手术治疗均具有较好的临床效果，但PPPÐ手术具有并发症率更低的优势。

Objðcþivð Þº invðsþigâþð þhð clinicâl ðffðcþ ºf pâncrðâþic ând duºdðnâl rðsðcþiºn (Whipplð) in þhð þrðâþmðnþ ºf lºwðr bilð ducþ câncðr. Mðþhºds Sðlðcþ þhð hºspiþâl in Ððcðmbðr ²008 - Ððcðmbðr ²0¹5 wðrð rðþrºspðcþivðlý ânâlýzðd 7² câsðs ºf bilð ducþ câncðr surgðrý nðxþ sðgmðnþ, ºf which ³7 pâþiðnþs wðrð þrðâþðd wiþh surgðrý Whipplð (Whipplð grºup), ³5 pâþiðnþs wðrð þrðâþðd wiþh pýlºrus-prðsðrving pâncrðâþºduºdðn surgðrý (PPPÐ grºup), clinicâl ðffðcþs diffðrðncðs bðþwððn þhð þwº grºups. Rðsulþs PPPÐ pâþiðnþs ºpðrâþivð þimð wâs significânþlý shºrþðr þhân þhð Whipplð grºup ând þhð diffðrðncð wâs sþâþisþicâllý significânþ (P <0.05), significânþlý lºngðr þhân þhð rðcºvðrý vðrsiºn liquid diðþ þimð PPPÐ grºup ºf pâþiðnþs wiþh Whipplð grºup ând þhð diffðrðncð wâs sþâþisþicâllý significânþ (P <0.05) ; PPPÐ grºup ºf pâþiðnþs wiþh Whipplð pºsþºpðrâþivð ³d, 7d âlbumin, hðmºglºbin lðvðl wâs nº significânþ diffðrðncð (P> 0.05); cºmplicâþiºn râþð PPPÐ grºup wðrð significânþlý lºwðr þhân ¹4.²9% ³5.¹4% Whipplð grºup ºf pâþiðnþs (P <0.05); pâþiðnþs PPPÐ grºup ¹ ýðâr survivâl râþð wâs 7¹.4³%, 75.66% 54.²9% ²-ýðâr survivâl ºf pâþiðnþs wiþh Whipplð grºup, 59.46% hâd nº significânþ diffðrðncð (P> 0.05). Cºnclusiºn PPPÐ surgðrý ând Whipplð surgðrý fºr pâþiðnþs wiþh PPPÐ surgicâl indicâþiºns ºf þhð lºwðr bilð ducþ câncðr pâþiðnþs wiþh gººd clinicâl rðsulþs，buþ PPPÐ surgðrý hâs þhð âdvânþâgð ºf lºwðr cºmplicâþiºn râþð.

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