Miyazaki I, Nagakawa T, Ohta T
Department of Surgery II, School of Medicine, Kanazawa University, Japan.
Gan To Kagaku Ryoho. 1992 Dec;19(14):2333-7.
Since 1973, we have applied extensive radical surgery for the head of the pancreas in order to improve not only the resection rate but also the surgical therapeutic results. The main points of our surgical procedure are as follows: (1) complete resection of surrounding connective tissues in retroperitoneum including extrapancreatic neural plexus. (2) extensive lymph node dissection, and (3) combined resection of the portal vein. As a result, our 3-year survival rate has increased to 31.4% and the 5-year survival rate to 27.9% in patients who underwent the macroscopically complete resection. These surgical therapeutic results are not satisfactory, but we have had 10 patients who survived more than 3 years. It is also true, however, that this procedure is extremely invasive and requires careful, long-term nutritional management after surgery. Therefore, the cooperation of not only the patients themselves but also their families is indispensable for the success of the treatment.
自1973年以来，我们对胰头实施了广泛的根治性手术，目的不仅是提高切除率，还为了改善手术治疗效果。我们手术方法的要点如下：（1）彻底切除包括胰外神经丛在内的腹膜后周围结缔组织。（2）广泛的淋巴结清扫，以及（3）门静脉联合切除。结果，在接受了肉眼可见的完整切除的患者中，我们的3年生存率提高到了31.4%，5年生存率提高到了27.9%。这些手术治疗效果并不令人满意，但我们有10名患者存活超过了3年。然而，同样确实的是，该手术具有极强的侵入性，术后需要仔细、长期的营养管理。因此，治疗成功不仅离不开患者自身，也离不开其家人的配合。
