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

Authors：

 郑斌 , 贾雷

甘肃省天水市第一人民医院普外科(甘肃天水 741000);

Corresponding author：

郑斌, Email: tszbzy@aliyun.com

Keywords：

结肠癌; 十二指肠瘘; 预后

DOI：

10.7507/1007-9424.20140021

Video：

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目的探讨因结肠癌侵犯所致十二指肠结肠瘘的诊疗方法。方法收集笔者所在医院1990年1月至2011年12月22年间收治的7例结肠癌并发十二指肠结肠瘘患者的临床资料，对其手术处理方式及愈后情况进行分析。结果 7例均行手术治疗，其中6例肿瘤切除，术后临床症状及体征消失，存活8～39个月后死亡，平均存活时间15.3个月；另1例未能行肿瘤切除，术后37 d因营养不良及多脏器功能衰竭死亡。结论十二指肠结肠瘘为结肠癌晚期并发症，手术根治效果差，术后生存时间由原发肿瘤特性决定；合理选择手术方式可以有效缓解患者痛苦，提高其生存质量并延长生存期。

Citation： 郑斌, 贾雷. 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.	郁宝铭.结肠肿瘤//吴孟超, 吴在德.黄家驷外科学[M].第7版.北京:人民卫生出版社, 2008:1558-1570.
2.	喻德洪.现代肛肠外科学[M].北京:人民军医出版社, 1997:345-360.
3.	夏立建, 刘爱武, 夏有恒, 等.十二指肠结肠瘘--结肠癌少见并发症[J].中华普通外科杂志, 2000, 15(11):694.
4.	黄信孚.大肠癌[M].成都:四川科学技术出版社, 1998:569-585.
5.	张庆荣.临床肛门大肠外科学[M].天津:天津科技翻译出版公司, 1992:211-235.
6.	黄信孚, 大肠癌//郑芝田.胃肠病学[M].北京:人民卫生出版社, 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.	韩继明, 乔渝春.十二指肠结肠瘘(附3例报告)[J].腹部外科杂志, 1997, 10(4):168-169.
13.	王炳章, 五振和, 郝凤池.十二指肠结肠瘘[J].中华医学杂志, 1978, 58(3):361-362.
14.	王晓玲, 于皆平, 冉宗学, 等.内镜对胃空肠结肠瘘及十二指肠结肠瘘的诊断价值[J].中华消化内镜杂志, 2003, 20(2):129-130.
15.	杨维良, 闫朝岐, 张好刚, 等.结肠肝曲癌侵犯十二指肠的外科治疗及预后[J].中华肿瘤杂志, 2009, 31(11):873-876.
16.	周建平, 刘祺, 舒国顺, 等.结肠肝曲癌侵犯十二指肠的外科治疗[J].中华普通外科杂志[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.右半结肠癌根治术合并十二指肠缺损修复治疗体会[J].临床肿瘤杂志, 2012, 17(1):52-54.
20.	刘宝善, 许玉成, 王辉, 等.大肠肛门肿瘤学[M].成都:四川科学技术出版社, 1998:427-441.
21.	张刚果, 傅红春.结肠肝曲癌侵犯十二指肠的外科治疗[J].感染、炎症、修复, 2006, 7(4):225-226.
22.	任峰, 周建平, 刘栋才, 等.带蒂全层回肠片修补十二指肠局部缺损[J].中国现代普通外科进展, 2010, 9(13):744-745.
23.	丁金火, 陈孝平.带蒂全层小肠段修补十二指肠巨大缺损(附7例报告)[J].中国普通外科杂志, 2000, 8(9):474-476.
24.	姜涛, 夏有恒.结肠肝曲癌侵犯十二指肠的外科治疗[J].中华普通外科杂志, 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.肠系膜上动脉压迫综合征//吴孟超, 吴在德.黄家驷外科学[M].第7版.北京:人民卫生出版社, 2008年:1477-1479.
27.	李仕青, 刘金新.结肠癌致十二指肠结肠瘘的手术处理[J].蚌埠医学院学报, 2000, 25(3):175-176.
28.	刘祺, 周建平, 舒国顺.右半结肠癌切除合并十二指肠缺损的处理[J].中国现代手术学杂志, 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, 詹文华, 汪建平, 等.结肠癌联合胰十二指肠切除术[J].中华胃肠外科杂志, 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. 郁宝铭.结肠肿瘤//吴孟超, 吴在德.黄家驷外科学[M].第7版.北京:人民卫生出版社, 2008:1558-1570.
2. 喻德洪.现代肛肠外科学[M].北京:人民军医出版社, 1997:345-360.
3. 夏立建, 刘爱武, 夏有恒, 等.十二指肠结肠瘘--结肠癌少见并发症[J].中华普通外科杂志, 2000, 15(11):694.
4. 黄信孚.大肠癌[M].成都:四川科学技术出版社, 1998:569-585.
5. 张庆荣.临床肛门大肠外科学[M].天津:天津科技翻译出版公司, 1992:211-235.
6. 黄信孚, 大肠癌//郑芝田.胃肠病学[M].北京:人民卫生出版社, 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. 韩继明, 乔渝春.十二指肠结肠瘘(附3例报告)[J].腹部外科杂志, 1997, 10(4):168-169.
13. 王炳章, 五振和, 郝凤池.十二指肠结肠瘘[J].中华医学杂志, 1978, 58(3):361-362.
14. 王晓玲, 于皆平, 冉宗学, 等.内镜对胃空肠结肠瘘及十二指肠结肠瘘的诊断价值[J].中华消化内镜杂志, 2003, 20(2):129-130.
15. 杨维良, 闫朝岐, 张好刚, 等.结肠肝曲癌侵犯十二指肠的外科治疗及预后[J].中华肿瘤杂志, 2009, 31(11):873-876.
16. 周建平, 刘祺, 舒国顺, 等.结肠肝曲癌侵犯十二指肠的外科治疗[J].中华普通外科杂志[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.右半结肠癌根治术合并十二指肠缺损修复治疗体会[J].临床肿瘤杂志, 2012, 17(1):52-54.
20. 刘宝善, 许玉成, 王辉, 等.大肠肛门肿瘤学[M].成都:四川科学技术出版社, 1998:427-441.
21. 张刚果, 傅红春.结肠肝曲癌侵犯十二指肠的外科治疗[J].感染、炎症、修复, 2006, 7(4):225-226.
22. 任峰, 周建平, 刘栋才, 等.带蒂全层回肠片修补十二指肠局部缺损[J].中国现代普通外科进展, 2010, 9(13):744-745.
23. 丁金火, 陈孝平.带蒂全层小肠段修补十二指肠巨大缺损(附7例报告)[J].中国普通外科杂志, 2000, 8(9):474-476.
24. 姜涛, 夏有恒.结肠肝曲癌侵犯十二指肠的外科治疗[J].中华普通外科杂志, 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.肠系膜上动脉压迫综合征//吴孟超, 吴在德.黄家驷外科学[M].第7版.北京:人民卫生出版社, 2008年:1477-1479.
27. 李仕青, 刘金新.结肠癌致十二指肠结肠瘘的手术处理[J].蚌埠医学院学报, 2000, 25(3):175-176.
28. 刘祺, 周建平, 舒国顺.右半结肠癌切除合并十二指肠缺损的处理[J].中国现代手术学杂志, 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, 詹文华, 汪建平, 等.结肠癌联合胰十二指肠切除术[J].中华胃肠外科杂志, 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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