Kang Chang Moo, Lee Jin Ho, Lee Woo Jung
Department of Surgery, Yonsei University College of Medicine, Pancreaticobiliary Cancer Clinic, Yonsei Cancer Center, Severance Hospital, 50 Yonsei-ro, Seodaemun-ku, Seoul, 120-752, Korea.
J Hepatobiliary Pancreat Sci. 2014 Dec;21(12):831-40. doi: 10.1002/jhbp.143. Epub 2014 Aug 25.
There is controversy regarding the recommended surgical approach for pancreatic tumors near the neck or proximal body of the pancreas. Unlike pancreatic cancer patients, those with benign and borderline (low-grade) malignant tumors of the pancreas are expected to have long-term survival after successful pancreatic resection. Therefore, surgeons need to consider not only oncologic safety, but also quality of life in their choice of surgical treatment. Laparoscopic central pancreatectomy (CP) is an ideal approach for pancreatic tumors near the neck or proximal body of the pancreas because it preserves endocrine and exocrine pancreatic function and conserves spleen function. Consequentially, CP can improve quality of life. However, there are no standardized studies supporting the use of laparoscopic CP. In this manuscript, we review the current status of minimally invasive CP in the advanced laparoscopic era and assess the quality of the evidence supporting the use of CP. We also propose future directions for scientific efforts to assess the utility of this surgical approach for benign and borderline malignant tumors near the neck of the pancreas.
对于胰腺颈部或胰体近端肿瘤的推荐手术方式存在争议。与胰腺癌患者不同，胰腺良性和交界性（低级别）恶性肿瘤患者在成功进行胰腺切除术后有望长期存活。因此，外科医生在选择手术治疗方式时不仅要考虑肿瘤学安全性，还要考虑生活质量。腹腔镜中央胰腺切除术（CP）是治疗胰腺颈部或胰体近端肿瘤的理想方法，因为它能保留胰腺的内分泌和外分泌功能，并保留脾脏功能。因此，CP可以提高生活质量。然而，目前尚无支持使用腹腔镜CP的标准化研究。在本手稿中，我们回顾了先进腹腔镜时代微创CP的现状，并评估了支持使用CP的证据质量。我们还提出了未来科学研究的方向，以评估这种手术方式对胰腺颈部良性和交界性恶性肿瘤的效用。
