Clinical analysis on diagnosis and treatment of 116 patients with primary duodenal malignant tumor
10.3760/cma.j.cn115455-20210726-00959
- VernacularTitle:116例原发性十二指肠恶性肿瘤的诊治分析
- Author:
Shun DENG
1
;
Bin YIN
;
Zhuo HE
;
Shuang WANG
;
Jinfeng WANG
;
Jianhong LUO
;
Yongzhong OUYANG
;
Jiangbo XIE
;
Bo HUANG
;
Fei BAI
;
Ke XIAO
;
Chaohui ZUO
Author Information
1. 中南大学湘雅医学院附属肿瘤医院暨湖南省肿瘤医院胃十二指肠胰腺外科 湖南省肿瘤医院（湖南省肿瘤防治研究所）肝癌转化医学联合研究中心和消化道肿瘤实验室，长沙 410013
- Keywords:
Duodenal neoplasms;
Pancreaticoduodenectomy;
Diagnosis;
Treatment outcome;
Retrospective studies
- From:
Chinese Journal of Postgraduates of Medicine
2021;44(11):999-1004
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnosis, surgical methods and therapeutic effect of primary duodenal malignant tumor.Methods:The clinical data of 116 patients with primary duodenal malignant tumor from January 2010 to December 2018 were retrospectively analyzed.Results:Among 116 patients, adenocarcinoma was in 74 cases, interstitial tumor was in 25 cases, carcinoid was in 9 cases, the others was in 8 cases. Before operation, duodenoscopy was performed in 107 cases, and CT examination was performed in 76 cases. There were 57 cases of pancreaticoduodenectomy, 15 cases of duodenal segmental resection, 13 cases of subtotal gastrectomy and duodenal bulbar resection, 13 cases of duodenal partial resection, and 18 cases of palliative short circuit operation. The total incidence of postoperative complication was 31.9% (37/116), including pancreatic fistula in 8 cases (grade B 5 cases, grade C 3 cases), biliary fistula in 6 cases, abdominal infection in 5 cases, pulmonary infection in 4 cases, intestinal fistula in 3 cases, delayed gastric emptying in 3 cases, and hemorrhage in 8 cases. Four cases (3.4%) died during the perioperative period. Single factor Cox regression analysis result showed that the postoperative survival time was related to the tumor differentiation degree, operation method, tumor infiltration degree and lymphatic metastasis ( P<0.05 or <0.01); multi-factor Cox regression analysis results showed that the operation method, tumor infiltration degree and lymphatic metastasis were the independent risk factors for the postoperative survival time of patients with primary duodenal malignant tumor ( P<0.05). The patients were followed up until June 2021, and 9 cases were lost to follow-up. Kaplan-Meier survival curve analysis result showed that the postoperative overall 1-,3- and 5-year survival rates were 82.11%, 57.56% and 33.11%, respectively. Conclusions:Adenocarcinoma is the main primary malignant tumor of duodenum. Duodenoscopy and CT are the main examination methods. Radical resection is the most effective treatment for primary duodenal malignant tumor, and pancreaticoduodenectomy is the first choice. Surgical method, tumor infiltration degree and lymphatic metastasis are the independent risk factors affecting the prognosis of patients.
