胆囊癌肝胰十二指肠联合切除严重并发症分析与处理
Journal of Abdominal Surgery（2016）
Abstract
目的 探索肝胰十二指肠联合切除(hepatopancreatoduodenectomy,HPD)术对胆囊癌(NevinⅣ)的治疗价值.方法 对19例胆囊癌病人行HPD术,术前酌情行门静脉栓塞(portal vein embolization,PVE),行经皮经肝穿刺胆道引流术(percutaneous transhepatic cholanic drainage,PTCD)减黄;观察术中、术后有无严重并发症及术后生存时间.结果 19例HPD病人未出现术中大出血、死亡等并发症,但1例病人术后出现肺栓塞猝死,1例肝衰竭,1例术后出现严重的肺部感染死亡,其余病人不同程度出现胆瘘及胰瘘等并发症.结论 HPD手术对胆囊癌达到R0切除有较大价值,能明显提高病人生存时间,但术后有严重的并发症及较高的病死率,需谨慎实施.
MoreKey words
Gallbladder carcinoma,Hepatopancreatoduodenectomy,Hepatic failure,Jaundice
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