The therapeutic method of pancreas cancer and _ treatment of the pluses and minuses

The therapeutic method of pancreas cancer and _ treatment of the pluses and minuses
1. Surgery treatment:
Effecting a radical cure operation: It is still the only effective curing the method of pancreas cancer at present, but the operation is complicated, the wound is big, the complication incidence is high.
Pancreas head cancer: Mainly there is a pancreas duodenum that excises the skill (Whipple skill) , the pancreas duodenum which keep stomach and pylorus excises the skill (PPPD skill) And the extended pancreas duodenum excises the skill. Whipple the intersection of pancreas and the intersection of head and the intersection of cancer and most classical the intersection of radical operation and way in skill among them, excise range, include the intersection of distal end portion and stomach, duodenum, the intersection of pancreas and head and underpart, person in over-all charge of gallbladder, generally, around not cleaning on pancreas head, in mesenterium around artery, mesenterium root formed sideways and around liver arteries total and liver duodenum lymph node in ligament. PPPD skill has kept the normal physiological function of the stomach, the backflow of stomach is prevented partly, have improved the nutritional status; In addition needn't walk the stomach part is excised, duodenum jejunum is identical and relatively simple, have shortened the time of operation. But it have think scholar this skill to under pylorus and there clean is lymph node around liver artery, may influence postoperative result, maintain only applicable on smaller the intersection of pancreas and the intersection of head and cancer, the intersection of duodenum and ball and pylorus portion person who invade; In addition, can find, should have a few patient take place the intersection of stomach and retention perform the operation, at being clinical. The intersection of pancreas and cancer present more growth of soaking etc., easy to infringe neighbouring portal vein and pulse of sound at the mesenterium around, a lot of scholars invaded tumour in the past and mesenterium blood vessel, sign whether pancreas cancer could be excised as judging of portal vein, so the excising rate is on the low side. The improvements of method and skill with performing the operation in recent years and enclosing the completion that dealt with of period of operation, implement the extended pancreas duodenum to excise to the persons who involve the blood vessel, portal vein on mesenterium partly, excise together blood vessel that involve tumour, until the intersection of body and blood vessel or artificial blood vessel rebuild the thorough fare of blood vessel since. But this skill type can improve survival rate and still have dispute. Because extended pancreas duodenum excision wound old and time long expecting much by technology, may increase the incidence of complication, so should choose prudently.
Pancreas body end cancer: Have simple the intersection of pancreas and the intersection of body and tail excise skill, extended the intersection of pancreas and the intersection of body and tail, excise the skill and unites the internal organs and excise the skill.
The whole pancreas is excised: Pancreas the intersection of cancer and competent the whole pancreas excise skill based on pancreas cancer many centre, have illness coming on theory, the whole pancreas has dispelled the possibility that the pancreas leaks complication after the pancreas duodenum is excised fundamentally after excising, but there are diabetes and pancreas exocrinosity function not to be complete to digest and assimilate sequela such as the obstacle. The near, long-term curative effect of studiesing have suggested the whole pancreas excises does not have obvious advantage, so should master indication strictly, only the whole pancreas cancer is absolute indication.
Guide the operation inside:
Single bypass operation: The gallbladder intestines are identical, identical, and the jejunum anastomosis of person in over-all charge of courage that the gallbladder jejunum is identical of mainly having gallbladder duodenums. The advantage can guide the bile, relieve jaundice, prepare for putting chemotherapy; The shortcoming is that some patients may present duodenal ileus in the future, and unable to solve the pancreatic juice to guide the problem.
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