Zhang Yi-jie, Hu Xian-gui, Jin Gang, Shao Cheng-hao, He Tian-lin, Li Gang, Jing Wei, Song Bin
Department of General Surgery, Second Military Medical University, Shanghai 200433, China.
Zhonghua Wai Ke Za Zhi. 2009 Nov 1;47(21):1627-9.
To improve the prognosis and safety of extended pancreaticoduodenectomy for patients with pancreatic cancer in the uncinate process of pancreas.
From January 2004 to March 2008, 26 extended pancreaticoduodenectomies with full length superior mesenteric artery (SMA) isolation and mesentery root resection were performed for the ductal adenocarcinomas in the uncinate process of pancreas. There were 16 males and 10 females aging from 30 to 75 years old [medium age (55.0 +/- 13.0) years old]. Eleven of 26 patients were combined with portal vein-superior mesenteric vein resection. The effect and safety of this procedure were analyzed retrospectively.
There was no operative mortality in all patients. The pathological examination showed that all the incisal margins were negative. After a follow-up of 7 to 45 months, the pain relief was occurred in all patients. The 1-year, 2-year accumulated survival rates were 72.2%, and 48.1%, respectively.
Full length SMA isolation and the mesentery resection in extended pancreaticoduodenectomy are safe and effective. The procedure is also benefit for the patients in improving the survival rate and quality of life.
提高胰头钩突部胰腺癌患者扩大胰十二指肠切除术的预后及安全性。
2004年1月至2008年3月，对26例胰头钩突部导管腺癌患者行扩大胰十二指肠切除术，术中完整游离肠系膜上动脉（SMA）全长并切除肠系膜根部。患者年龄30～75岁，男16例，女10例，中位年龄（55.0±13.0）岁。26例患者中11例联合门静脉-肠系膜上静脉切除。对该手术方式的疗效及安全性进行回顾性分析。
所有患者均无手术死亡。病理检查显示切缘均为阴性。随访7～45个月，所有患者疼痛均缓解。1年、2年累计生存率分别为72.2%、48.1%。
扩大胰十二指肠切除术中完整游离SMA全长并切除肠系膜是安全有效的。该手术方式有利于提高患者生存率及生活质量。
