Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Curr Opin Gastroenterol. 2012 Sep;28(5):488-93. doi: 10.1097/MOG.0b013e3283567f2c.
Pancreatic resection remains among the most formidable and complex of abdominal surgical operations. Nonetheless, recent observations have continued to provide incremental improvement in both our evidence for treatment regimens and the technology, resulting in better outcomes.
Neoadjuvant regimens appear to have promise, at least in local control and perhaps in long-term survival. More extensive operations focusing on perineural invasion along with minimally invasive laparoscopic and robotic techniques are attracting increasing attention. The effectiveness of major vascular resection remains controversial. Concentration of patients in centers of expertise has contributed to improved outcomes.
Improved management of pancreatic resections for cancer with more extensive and less-invasive surgical techniques has increased the number of patients who are candidates for effective surgical treatment.
胰腺切除术仍然是腹部外科手术中最具挑战性和复杂性的手术之一。尽管如此,最近的观察结果继续为我们的治疗方案提供了渐进式的改进,并推动了技术的发展,从而带来了更好的结果。
新辅助方案似乎有希望,至少在局部控制方面,甚至在长期生存方面。更广泛的手术侧重于神经周围侵犯,同时结合微创腹腔镜和机器人技术,正吸引着越来越多的关注。主要血管切除的有效性仍然存在争议。将患者集中在专业中心有助于改善结果。
更广泛和微创的手术技术对胰腺癌切除术的改进管理增加了适合有效手术治疗的患者数量。