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目的 探讨对Vater壶腹部肿瘤行壶腹部扩大切除的手术方法。方法 1995～ 1998年行壶腹部癌扩大的局部切除术 8例。切除范围包括肝外胆道、胆胰管汇合部、壶腹部及十二指肠降部后外侧壁乳头区。结果 围手术期死亡 1例。术后外压性十二指肠梗阻 1例 ,经再手术治愈。术后随访半年以上 7例 ,最长生存 2 9个月 ,无并发症及转移征象。结论 该术式虽为局部切除但可达到广泛淋巴清扫的目的 ,符合肿瘤的治疗原则。
Objective To explore the surgical method for the ampulla enlarged resection of Vater ampullary tumor. Methods From 1995 to 1998, 8 patients underwent extensive local resection of ampullary carcinoma. The resection range included extrahepatic biliary tract, biliary-pancreatic duct confluence, ampulla and duodenal descending posterior lateral nipple region. Results One patient died during perioperative period. After operation, one case of external pressure duodenal obstruction was cured by reoperation. Seven patients were followed up for more than half a year after surgery, and the longest survival was 29 months. There were no complications or metastases. Conclusions Although this procedure is a partial resection, it can achieve a wide range of lymphatic dissections, which is consistent with the principle of treatment of tumors.