سرطان مجل فاتر تشخيص وتدبير
Abstract
شملت الدراسة 71 مريضاً قبلوا في مشفى الأسد الجامعي باللاذقية بين عامي 1992-2007، اليرقان الصامت المتموّج المترقي كان الشكاية الأكثر شيوعاً بنسبة 96%. تم تقسيم المرضى لأربع مجموعات حسب التدبير: استئصال المعثكلة والعفج عند 11 مريضاً، واستئصال المجل موضعياً عند 9 مرضى،وإجراءات جراحية تلطيفية عند 30 مريضاً ، وأجري الـ ERCP العلاجي مع وضع Stent عند 21 مريضاً.
36% من المرضى الذين خضعوا للجراحة كانوا في المرحلة ( Stage III) حسب تصنيف TNM.
السرطانة الغدية هي الأكثر توارداً بالتشريح المرضي بنسبة 81.9%.
كانت النواسير المعثكلية من أهم المضاعفات ما بعد الجراحة. وحدثت حالتا وفاة.
الكبد هو الموضع الأول للنكس البعيد ( النقائل البعيدة) .
الاستئصال المعثكلي العفجي ( ويبل وتعديلاتها) هو إجراء آمن وذو نتائج جيدة ومعدل بقيا جيد.
This study includes 71 patients admitted to Al-Assad University Hospital in Lattakia between 1992 and 2007. The most common symptom has been silent fluctuant jaundice 96%. According to management, patients are divided into four groups: pancreaticodnodnodenctomy is done on 11 patients, local resection of Vater's ampulla procedure is carried out on 9 patients, palliative operations on 30 patients, and ERCP +Stent is performed on 21 patients. 36% of patients who have undergone surgery are classified as Stage III. Pathologically, 81.9 % of patients have Adenocarcinoma. Pancreatic fistulas are the most common post-operation complications; two patients are reported dead. The liver is the most common place for metastasis. Pancreaticodnodnodenctomy is a safe procedure with good results and high rescue rate.
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