A Report of 7 Cases of Malignant Duodenal Fistula and Review of The Literatures_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 鄭斌 , 賈雷

甘肅省天水市第一人民醫院普外科(甘肅天水 741000);

Corresponding?author：

鄭斌, Email: tszbzy@aliyun.com

Keywords：

結腸癌; 十二指腸瘺; 預后

DOI：

10.7507/1007-9424.20140021

Video：

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Abstract Full text Figures/Tables Video References Cited by

目的探討因結腸癌侵犯所致十二指腸結腸瘺的診療方法。方法收集筆者所在醫院1990年1月至2011年12月22年間收治的7例結腸癌并發十二指腸結腸瘺患者的臨床資料，對其手術處理方式及愈后情況進行分析。結果 7例均行手術治療，其中6例腫瘤切除，術后臨床癥狀及體征消失，存活8～39個月后死亡，平均存活時間15.3個月；另1例未能行腫瘤切除，術后37 d因營養不良及多臟器功能衰竭死亡。結論十二指腸結腸瘺為結腸癌晚期并發癥，手術根治效果差，術后生存時間由原發腫瘤特性決定；合理選擇手術方式可以有效緩解患者痛苦，提高其生存質量并延長生存期。

Citation： 鄭斌, 賈雷. A Report of 7 Cases of Malignant Duodenal Fistula and Review of The Literatures. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(1): 95-97. doi: 10.7507/1007-9424.20140021 Copy

1.	郁寶銘.結腸腫瘤//吳孟超, 吳在德.黃家駟外科學[M].第7版.北京:人民衛生出版社, 2008:1558-1570.
2.	喻德洪.現代肛腸外科學[M].北京:人民軍醫出版社, 1997:345-360.
3.	夏立建, 劉愛武, 夏有恒, 等.十二指腸結腸瘺--結腸癌少見并發癥[J].中華普通外科雜志, 2000, 15(11):694.
4.	黃信孚.大腸癌[M].成都:四川科學技術出版社, 1998:569-585.
5.	張慶榮.臨床肛門大腸外科學[M].天津:天津科技翻譯出版公司, 1992:211-235.
6.	黃信孚, 大腸癌//鄭芝田.胃腸病學[M].北京:人民衛生出版社, 1986:543-560.
7.	Haldane DR.Case of cancer of the caecum, accompanied by with caeco duodenal and caeco colic fistulae[J].Edinburgh Med J, 1862, 7(5):624-629.
8.	Hershenson LM, Kirsner JB.Duodenocolic fistula[J].Gastroenterology, 1951, 19(4):864-873.
9.	Welch JP, Warshaw AL.Malignant duodenocolic fistulas[J].Am J Sourg, 1977, 133(6):658-661.
10.	Chung DP, Li RS, Leong HT.Diagnosis end current management of gastrojejunocolic fistula[J].Hong Kong Med J, 200l, 7(4):439-441.
11.	Steer ML, Glotzer DJ.Colonic exclusion by pass principle:its use in the palliative treatment of malignant duodenocolic and gast-rocolic fistulas[J].Arch Surg, 1980, 115(1):87-89.
12.	韓繼明, 喬渝春.十二指腸結腸瘺(附3例報告)[J].腹部外科雜志, 1997, 10(4):168-169.
13.	王炳章, 五振和, 郝鳳池.十二指腸結腸瘺[J].中華醫學雜志, 1978, 58(3):361-362.
14.	王曉玲, 于皆平, 冉宗學, 等.內鏡對胃空腸結腸瘺及十二指腸結腸瘺的診斷價值[J].中華消化內鏡雜志, 2003, 20(2):129-130.
15.	楊維良, 閆朝岐, 張好剛, 等.結腸肝曲癌侵犯十二指腸的外科治療及預后[J].中華腫瘤雜志, 2009, 31(11):873-876.
16.	周建平, 劉祺, 舒國順, 等.結腸肝曲癌侵犯十二指腸的外科治療[J].中華普通外科雜志[J].2006, 5(21):371-372.
17.	Jagoditsch M, Lisborg PH, Jatzko GR, et al.Long-term progn-osis for colon cancer related to consistent radical surgery:multiv-ariate analysis of clinical, surgical, and pathologic variables[J].World J Surg, 2000, 24(10):1264-1270.
18.	Poeze M, Houbiers JG, van de Velde CJ, et al.Radical resection of locally advanced colon cancer[J].Br J Surg, 1995, 82(10):1386-1390.
19.	文政琦, 李文亮, 蔡宇, 等.右半結腸癌根治術合并十二指腸缺損修復治療體會[J].臨床腫瘤雜志, 2012, 17(1):52-54.
20.	劉寶善, 許玉成, 王輝, 等.大腸肛門腫瘤學[M].成都:四川科學技術出版社, 1998:427-441.
21.	張剛果, 傅紅春.結腸肝曲癌侵犯十二指腸的外科治療[J].感染、炎癥、修復, 2006, 7(4):225-226.
22.	任峰, 周建平, 劉棟才, 等.帶蒂全層回腸片修補十二指腸局部缺損[J].中國現代普通外科進展, 2010, 9(13):744-745.
23.	丁金火, 陳孝平.帶蒂全層小腸段修補十二指腸巨大缺損(附7例報告)[J].中國普通外科雜志, 2000, 8(9):474-476.
24.	姜濤, 夏有恒.結腸肝曲癌侵犯十二指腸的外科治療[J].中華普通外科雜志, 2005, 3(14):200-202.
25.	Fujiwara H, Yamasaki M, Nakamura S, et al.Reconstruction of a large duodenal defect created by resection of a duodenal tubulo-villous adenoma using adouble-tract anastomosis to a retrocolic Roux-en-Y loop:report of a case[J].Surg Today, 2002, 32(9):824-827.
26.	王吉甫.腸系膜上動脈壓迫綜合征//吳孟超, 吳在德.黃家駟外科學[M].第7版.北京:人民衛生出版社, 2008年:1477-1479.
27.	李仕青, 劉金新.結腸癌致十二指腸結腸瘺的手術處理[J].蚌埠醫學院學報, 2000, 25(3):175-176.
28.	劉祺, 周建平, 舒國順.右半結腸癌切除合并十二指腸缺損的處理[J].中國現代手術學雜志, 2006, 10(2):109-11l.
29.	Perez RO, Coser RB, Kiss DR, et al.Combined resection of the duodenum and pancreas for locally advanced colon cancer[J].Curr Surg, 2005, 62(6):613-617.
30.	Saiura A, Yamamoto J, Ueno M, et al.long-term survival inpatients with locally advanced colon cancer after en bloc pancreatic oduodenectomy and colectomy[J].Dis Colon Rectum, 2008, 51(10):1548-1551.
31.	Fuks D, Pessaux P, Tuech JJ, et al.Management of patients with carcinoma of the right colon invading the duodenum or pancreatic head[J].Int J Colorectal Dis, 2008, 23(5):477-481.
32.	Linton RR.Two-stage operation for carcinoma of transverse colon producing duodenocolic fistula[J].Arch Surg, 1944, 48(3):197-207.
33.	Song XM, Wang L, Zhan WH, et al.Right hemicolectomy combined with pancreatico-duodenectomy for the treatment of colon carcinoma invading the duodenum or pancreas[J].Chin Med J (Eugl), 2006, 119(20):1740-1743.
34.	宋新明, 詹文華, 汪建平, 等.結腸癌聯合胰十二指腸切除術[J].中華胃腸外科雜志, 2004, 7(1):35-37.
35.	Kapoor S, Das B, Pal S, et al.En bloc resection of right-sided colonic sdenocarcinona with adjacent organ invasion[J].Int J Colorectal Dis, 2006, 21(3):265-268.
36.	Berrospi F, Celis J, Ruiz E, et al.En bloc pancreaticoduodenectomy for right colon cancer invading adjacent orguns[J].J Surg Oncol, 2002, 79(3):194-197.
37.	Hunter JA, Ryan JA Jr, Schultz P.En bloc resection of colon colon adherent to other organs[J].Am J Surg, 1987, 154(1):67-71.

1. 郁寶銘.結腸腫瘤//吳孟超, 吳在德.黃家駟外科學[M].第7版.北京:人民衛生出版社, 2008:1558-1570.
2. 喻德洪.現代肛腸外科學[M].北京:人民軍醫出版社, 1997:345-360.
3. 夏立建, 劉愛武, 夏有恒, 等.十二指腸結腸瘺--結腸癌少見并發癥[J].中華普通外科雜志, 2000, 15(11):694.
4. 黃信孚.大腸癌[M].成都:四川科學技術出版社, 1998:569-585.
5. 張慶榮.臨床肛門大腸外科學[M].天津:天津科技翻譯出版公司, 1992:211-235.
6. 黃信孚, 大腸癌//鄭芝田.胃腸病學[M].北京:人民衛生出版社, 1986:543-560.
7. Haldane DR.Case of cancer of the caecum, accompanied by with caeco duodenal and caeco colic fistulae[J].Edinburgh Med J, 1862, 7(5):624-629.
8. Hershenson LM, Kirsner JB.Duodenocolic fistula[J].Gastroenterology, 1951, 19(4):864-873.
9. Welch JP, Warshaw AL.Malignant duodenocolic fistulas[J].Am J Sourg, 1977, 133(6):658-661.
10. Chung DP, Li RS, Leong HT.Diagnosis end current management of gastrojejunocolic fistula[J].Hong Kong Med J, 200l, 7(4):439-441.
11. Steer ML, Glotzer DJ.Colonic exclusion by pass principle:its use in the palliative treatment of malignant duodenocolic and gast-rocolic fistulas[J].Arch Surg, 1980, 115(1):87-89.
12. 韓繼明, 喬渝春.十二指腸結腸瘺(附3例報告)[J].腹部外科雜志, 1997, 10(4):168-169.
13. 王炳章, 五振和, 郝鳳池.十二指腸結腸瘺[J].中華醫學雜志, 1978, 58(3):361-362.
14. 王曉玲, 于皆平, 冉宗學, 等.內鏡對胃空腸結腸瘺及十二指腸結腸瘺的診斷價值[J].中華消化內鏡雜志, 2003, 20(2):129-130.
15. 楊維良, 閆朝岐, 張好剛, 等.結腸肝曲癌侵犯十二指腸的外科治療及預后[J].中華腫瘤雜志, 2009, 31(11):873-876.
16. 周建平, 劉祺, 舒國順, 等.結腸肝曲癌侵犯十二指腸的外科治療[J].中華普通外科雜志[J].2006, 5(21):371-372.
17. Jagoditsch M, Lisborg PH, Jatzko GR, et al.Long-term progn-osis for colon cancer related to consistent radical surgery:multiv-ariate analysis of clinical, surgical, and pathologic variables[J].World J Surg, 2000, 24(10):1264-1270.
18. Poeze M, Houbiers JG, van de Velde CJ, et al.Radical resection of locally advanced colon cancer[J].Br J Surg, 1995, 82(10):1386-1390.
19. 文政琦, 李文亮, 蔡宇, 等.右半結腸癌根治術合并十二指腸缺損修復治療體會[J].臨床腫瘤雜志, 2012, 17(1):52-54.
20. 劉寶善, 許玉成, 王輝, 等.大腸肛門腫瘤學[M].成都:四川科學技術出版社, 1998:427-441.
21. 張剛果, 傅紅春.結腸肝曲癌侵犯十二指腸的外科治療[J].感染、炎癥、修復, 2006, 7(4):225-226.
22. 任峰, 周建平, 劉棟才, 等.帶蒂全層回腸片修補十二指腸局部缺損[J].中國現代普通外科進展, 2010, 9(13):744-745.
23. 丁金火, 陳孝平.帶蒂全層小腸段修補十二指腸巨大缺損(附7例報告)[J].中國普通外科雜志, 2000, 8(9):474-476.
24. 姜濤, 夏有恒.結腸肝曲癌侵犯十二指腸的外科治療[J].中華普通外科雜志, 2005, 3(14):200-202.
25. Fujiwara H, Yamasaki M, Nakamura S, et al.Reconstruction of a large duodenal defect created by resection of a duodenal tubulo-villous adenoma using adouble-tract anastomosis to a retrocolic Roux-en-Y loop:report of a case[J].Surg Today, 2002, 32(9):824-827.
26. 王吉甫.腸系膜上動脈壓迫綜合征//吳孟超, 吳在德.黃家駟外科學[M].第7版.北京:人民衛生出版社, 2008年:1477-1479.
27. 李仕青, 劉金新.結腸癌致十二指腸結腸瘺的手術處理[J].蚌埠醫學院學報, 2000, 25(3):175-176.
28. 劉祺, 周建平, 舒國順.右半結腸癌切除合并十二指腸缺損的處理[J].中國現代手術學雜志, 2006, 10(2):109-11l.
29. Perez RO, Coser RB, Kiss DR, et al.Combined resection of the duodenum and pancreas for locally advanced colon cancer[J].Curr Surg, 2005, 62(6):613-617.
30. Saiura A, Yamamoto J, Ueno M, et al.long-term survival inpatients with locally advanced colon cancer after en bloc pancreatic oduodenectomy and colectomy[J].Dis Colon Rectum, 2008, 51(10):1548-1551.
31. Fuks D, Pessaux P, Tuech JJ, et al.Management of patients with carcinoma of the right colon invading the duodenum or pancreatic head[J].Int J Colorectal Dis, 2008, 23(5):477-481.
32. Linton RR.Two-stage operation for carcinoma of transverse colon producing duodenocolic fistula[J].Arch Surg, 1944, 48(3):197-207.
33. Song XM, Wang L, Zhan WH, et al.Right hemicolectomy combined with pancreatico-duodenectomy for the treatment of colon carcinoma invading the duodenum or pancreas[J].Chin Med J (Eugl), 2006, 119(20):1740-1743.
34. 宋新明, 詹文華, 汪建平, 等.結腸癌聯合胰十二指腸切除術[J].中華胃腸外科雜志, 2004, 7(1):35-37.
35. Kapoor S, Das B, Pal S, et al.En bloc resection of right-sided colonic sdenocarcinona with adjacent organ invasion[J].Int J Colorectal Dis, 2006, 21(3):265-268.
36. Berrospi F, Celis J, Ruiz E, et al.En bloc pancreaticoduodenectomy for right colon cancer invading adjacent orguns[J].J Surg Oncol, 2002, 79(3):194-197.
37. Hunter JA, Ryan JA Jr, Schultz P.En bloc resection of colon colon adherent to other organs[J].Am J Surg, 1987, 154(1):67-71.

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A Report of 7 Cases of Malignant Duodenal Fistula and Review of The Literatures

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