Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
J Hepatobiliary Pancreat Sci. 2012 May;19(3):210-5. doi: 10.1007/s00534-011-0480-8.
Pylorus-preserving pancreatoduodenectomy has become a standard operation for distal and middle bile duct cancers. Bile duct cancer typically extends longitudinally and invades vertically. It frequently metastasizes to the lymph nodes and infiltrates the perineural spaces. The presence of residual cancer in the bile duct stump and lymph node metastases are significant prognostic factors. Negative surgical margins and D2 lymph node dissection are necessary for curative resection. The clinical course after portal vein resection for bile duct cancer with portal vein invasion is better than that of non-resectable bile duct cancer. Portal vein resection can therefore be useful. The efficacy of prophylactic portal vein resection is unclear. We describe here our methods for performing pylorus-preserving pancreatoduodenectomy for bile duct cancer.
保留幽门的胰十二指肠切除术已成为治疗远端和中段胆管癌的标准手术。胆管癌通常呈纵向延伸并垂直侵犯。它经常向淋巴结转移并浸润神经周围间隙。胆管残端存在肿瘤残余和淋巴结转移是重要的预后因素。阴性手术切缘和 D2 淋巴结清扫是根治性切除的必要条件。对于伴有门静脉侵犯的胆管癌行门静脉切除后的临床过程优于不可切除的胆管癌。因此，门静脉切除是有用的。预防性门静脉切除的疗效尚不清楚。我们在此描述了我们用于治疗胆管癌的保留幽门的胰十二指肠切除术的方法。
