Maeda Hiromichi, Okabayashi Takehrio, Nishimori Isao, Kobayashi Michiya, Sugimoto Takeki, Kohsaki Takuhiro, Onishi Saburo, Hanazaki Kazuhiro
Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku-City, Kochi, 783-8505, Japan.
Langenbecks Arch Surg. 2007 Sep;392(5):649-52. doi: 10.1007/s00423-007-0204-3. Epub 2007 Jun 29.
We report a case of duodenum-preserving pancreatic head resection (DPPHR) for the treatment of pancreatic head metastasis from renal cell carcinoma (RCC).
The patient was a 59-year-old male with a medical history of RCC 18 years ago. Abdominal imaging studies revealed a hypervascular mass localized in the pancreatic head without distant metastasis or tumor invasion into the adjacent organs including the common bile duct and duodenum. Under the preoperative diagnosis of pancreatic metastasis from RCC, the tumor was completely resected by DPPHR. The pathological examination of the resected specimen confirmed the preoperative diagnosis.
As lymph node metastasis has been rarely reported in previous cases of pancreatic metastasis from RCC, DPPHR should be considered as a less invasive surgical option to provide a favorable postoperative quality of life (QOL).
我们报告一例保留十二指肠的胰头切除术（DPPHR）用于治疗肾细胞癌（RCC）胰头转移的病例。
该患者为一名59岁男性，有18年前肾细胞癌病史。腹部影像学检查显示胰头有一个富血管肿块，无远处转移，肿瘤未侵犯包括胆总管和十二指肠在内的邻近器官。在术前诊断为肾细胞癌胰腺转移的情况下，通过保留十二指肠的胰头切除术将肿瘤完全切除。切除标本的病理检查证实了术前诊断。
由于既往肾细胞癌胰腺转移病例中很少有淋巴结转移的报道，保留十二指肠的胰头切除术应被视为一种侵入性较小的手术选择，以提供良好的术后生活质量（QOL）。
