老年人壶腹周围癌胰十二指肠切除27例疗效分析

目的 探讨70岁以上壶腹周围癌患者行胰十二指肠切除的指征和疗效。方法 对27例年龄超过70岁的壶腹周围癌患者，行胰十二指肠切除治疗后的临床病例资料进行回顾性分析。结果 术后外科并发症12例(44．4％)，包括腹腔内出血3例，消化道出血2例，胰瘘3例，胃潴留4例，切口裂开及感染3例，其中3例(11．1％)在术后30天内死亡。平均生存15．3个月(除外8例术后18个月仍健在者)。有4例生存超过3年，3年生存率21．0％(4／19)。结论 患者年龄因素不是胰十二指肠切除的禁忌证，胰十二指肠切除是治疗70岁以上患者壶腹周围癌的有效手段。

The Results of Pancreaticoduodenectomy for 27 Old Patients with Periampullary Cancer

Objective To investigate the indications and therapeutic effects of pancreaticoduodenectomy in patients more than 70 years old with periampullary cancer.Methods A retrospective analysis of 27 consecutive patients more than 70 years old who had underwent pancreaticoduodenectomies from Jan 1995 to June 2002 was made.Results Postoperative complications occurred in 12 patients(44.4%),including 3 cases of intraabdominal bleedings,2 gastrointestinal bleedings,3 pancreatic leakages,4 gastroparalysis and 3 wound infections.Three patients(11.1%) died within 30 days postoperatively.The average survival time was 15.3 months except for 8 patients who are still alive 18 months aften operation.Four patients survived more than 3 years with 3-year survival rate of 21.0%(4/19).Conclusion Old people is not a contraindication of pancreaticoduodenectomy.Pancreaticoduodenectomy is an effective method for patients more than 70 years of age with periampullary cancer.