区域性胰腺切除术：整块切除胰腺、门静脉和淋巴结。
Regional pancreatectomy: en bloc pancreatic, portal vein and lymph node resection.
作者信息
Fortner J G, Kim D K, Cubilla A, Turnbull A, Pahnke L D, Shils M E
出版信息
Ann Surg. 1977 Jul;186(1):42-50. doi: 10.1097/00000658-197707000-00007.
Abstract
Eighteen patients are reported who have had a regional pancreatectomy. The pancreatic segment of portal vein was excised with en bloc total pancreatectomy and regional lymph node dissection in all 18. Venous repair was by end-to-end anastomosis without a graft. Five of the 18 also had various arterial resections and reconstructions. Sixteen of the 18 had been explored and deemed nonresectable elsewhere. This operation has doubled the resectability rate in this institution. The 30-day operative mortality rate was 16.6%. Acurarial survival is 62% at one year compared with 36% one year survival rate for patients undergoing pancreaticoduodenectomy for less advanced cancer in previous years. A more valid comparison would be between those who had a palliative procedure since most patients in the present series were initially considered unresectable. One year survival for these patients was 22%. The quality of life was good for most patients.
摘要
报告了18例接受区域性胰腺切除术的患者。在所有18例手术中，门静脉的胰腺段均与全胰腺整块切除及区域淋巴结清扫一并切除。静脉修复采用端端吻合，未使用移植物。18例中有5例还进行了各种动脉切除和重建。18例中有16例曾在其他地方接受探查，被认为无法切除。该手术使本机构的可切除率提高了一倍。30天手术死亡率为16.6%。1年实际生存率为62%，而前几年因癌症进展较轻接受胰十二指肠切除术的患者1年生存率为36%。更有效的比较应该是与那些接受姑息性手术的患者，因为本系列中的大多数患者最初被认为无法切除。这些患者的1年生存率为22%。大多数患者的生活质量良好。
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