Liu Hongming, Liu Menggang, Yuan Tao, Tang Chun, Chen Ping
Third Military Medical University, Department of Hepatobiliary Surgery, Daping Hospital, Chongqing 400042, PR China.
Med Hypotheses. 2009 Aug;73(2):187-8. doi: 10.1016/j.mehy.2009.02.024. Epub 2009 Apr 16.
The pancreatic leakage is a lethal postoperative complication to the patients after duodenopancreatectomy for carcinoma of head of pancreas. However, we found that the patients who survived this lethal postoperative complication could potentially acquire a longer survival time comparing with those without postoperative pancreatic leakage. We surmise pancreatic enzyme can destroy tumor cell directly by its strong corrosive action. On the other hand, pancreatic leakage can lead to severe bacterial infection which cause serial inflammatory reaction and immunological reaction. We hypothesize that celiac infection after pancreatic leakage might prevent cancer cellstransfuse to liver along duodenohepatic ligament. Our hypothesis might provide a novel therapeutic strategy for patients who underwent radical duodenopancreatectomy. For instance, the exogenous infection or controlling pancreatic leakage may be reasonable and deserve further study. With the aid of animal model of carcinoma of head of pancreas, this hypothesis could be partially or fully confirmed.
胰漏是胰头癌患者行胰十二指肠切除术后的一种致命性术后并发症。然而，我们发现，在这种致命性术后并发症中存活下来的患者与没有术后胰漏的患者相比，有可能获得更长的生存时间。我们推测胰酶可凭借其强大的腐蚀作用直接破坏肿瘤细胞。另一方面，胰漏可导致严重的细菌感染，引发一系列炎症反应和免疫反应。我们假设胰漏后的腹腔感染可能会阻止癌细胞沿十二指肠肝韧带转移至肝脏。我们的假设可能为接受根治性胰十二指肠切除术的患者提供一种新的治疗策略。例如，外源感染或控制胰漏可能是合理的，值得进一步研究。借助胰头癌动物模型，这一假设可能会得到部分或完全证实。
