's treatment of therapeutic method of pancreas cancer

's treatment of therapeutic method of pancreas cancer
The surgery treatment is pancreas cancer " Cure " The best choice. Unfortunately, about 80% of the patients are unable to try this kind of treatment. Because of the phased improvement recently, some author reports undergo an operation the therapeutic patient's proportion rises to some extent.
In 1935, Wipple, Parsonst and Mullins reported the second stage of a case of pancreas duodenum excised the skill, this example was belly cancer of a pot, the duodenum is all excised. Up till now, basically continue to use this kind of operation way, and one is finished, call it Whipple (Wipple) Operation.

1,Prepare before the skill:
May choose generally needing to prepare the basic physiology before the skill of patient of Wipple operation. Age is not a taboo question of excising the skill. If patient take in difference, have sick to vomit, appropriate supplementary moisture key in front of the skill. Should it corrects water and electrolytes to be disorderly in front of the skill, prevent, take place kidney decline while being postoperative. Because bile duct stop up and bring out cholangitis, worsen with liver function often, albuminous level and blood coagulation test it is extremely apt liver function that go on that determine the law. Inject vitamin k, or fresh freezing the blood plasma, can resume the patient's blood coagulation mechanism. Advocate, carry on outside the body guiding to bile duct that stop up in front of skill seldom, will soon take place guide, the intersection of fungus and clump grow, further damage liver function. The function that the bile of endoscope guides awaits to affirm fully at this moment.

It is all helpful to strengthen cardiovascularly and monitor before the skill, in the skill and postoperative. Because need to hold the conduit outside the hard membrane in order to control postoperative pain, keep in touch with the function for the lung that improves the patient at the same time. It is essential to enclose the application of antibiotic of period for the operation.

2,Excising operation
If any position in these areas on surface of peritoneum, omentum, liver and transverse colon is infringed, the pancreas excises the skill not to do it. And the patient that needs other treatments not to need surgery to some, it is important that histologic judgement is true.

" keep pylorus " Whipple operation has been to a kind of improvement of Wipple operation recently, it keeps first part of the duodenum, maintaining the normal stomach capacity can improve the nutritional status. Because of keeping pylorus, probably remain some tumours because of neglecting, the fact proves too that there is this kind of possibility.

3,Complication
Complication of Wipple operation is septicaemia, gallbladder Lou or pancreatic fistulaed, and bleeds. Mortality fluctuates in 27%- 46%. The emergence of septicaemia is often because of coming from gastrointestinal blood retention or leaking, a lot of cases are taken and punctured and guided this kind of invasion treatment method by the cover. Pancreatic fistula happens to 10%- 18% of the patients, the manifestation of pancreatic fistula is similar to septicaemia, 7%- 10% mortality relates to pancreatic fistula. The postoperative bleeding that takes place immediately is usually the not ligature of blood vessel well, or because of the blood clot in the blood vessel that is not found. Bleeding of person who send might because of septicaemia or Lou form cause artery necrosis and the ligature line is lossed late. It is postoperative for pancreas to excise, especially pylorus keep stomach behind the operation empty, it delays to be one as to having complicationing that lifing threatening common, but may bring out some peritonitis. Complication with lower incidence is as follows, intestinal obstruction, the intersection of mesenterium and thrombus, the intersection of liver function and depleted, cholangitis, pancreatitis, the intersection of renal function and depleted and necrosis nature membrane inflammation of muscle.

4,Survival rate
Up till now, it is accepted that the pancreas 12 means survival rate is extremely low in pancreas cancer patient excising the skill's 5. From 3%- 25% according to the report. Report once in a while the patient with very big tumour survives for a long time, but the great majority of the persons who survive are the little focus, not lymphocytic to infringe ( T1, N0, M0) . Average life cycle after the pancreas is excised is 17 months. Recent research points out, enclose operation period blood transfusion is harmful to the pancreas duodenum and excise postoperative survival rate. In addition, tumour DNA one time of sex and cell proliferate the index like quantity of big or small and positive lymph node of tumour, or indicate the situation of surviving more clearly.
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