Patyutko Yu I, Abgaryan M G, Kudashkin N E, Kotelnikov A G
Blokhin Russian Cancer Research Center, Ministry of Health of the Russian Federation, Moscow, Russia.
Khirurgiia (Mosk). 2016(11):8-18. doi: 10.17116/hirurgia2016118-18.
To show the advisability, satisfactory tolerance and good analgesic effect of surgery for pancreatic ductal carcinoma with celiac trunk invasion.
Distal subtotal pancreatectomy with resection of celiac trunk and common hepatic artery was made in 21 patients.
Early postoperative complications after distal subtotal pancreatectomy with celiac trunk resection occurred in 10 (47.6%) patients. There was no postoperative mortality. Resection edges including retroperitoneal space and pancreas did not contain tumor cells according to histological examination. Complete analgesic effect was obtained in 100% of patients after distal subtotal pancreatectomy with celiac trunk resection and neurodissection. 1- and 2-year survival was 59.1% and 21.5% respectively in patients with locally advanced pancreatic ductal carcinoma who underwent distal subtotal pancreatectomy with celiac trunk resection, median - 13 months, maximum lifetime - 57 months.
Distal subtotal pancreatectomy with resection of celiac trunk and common hepatic artery is safe, provides significant analgesic effect, increases resectability and expands the indications for pancreatectomy.
展示对伴有腹腔干侵犯的胰腺导管癌进行手术的可取性、良好的耐受性和镇痛效果。
对21例患者实施了远端胰腺次全切除术，同时切除腹腔干和肝总动脉。
21例接受了远端胰腺次全切除并切除腹腔干的患者中，有10例（47.6%）出现了术后早期并发症。无术后死亡病例。根据组织学检查，包括腹膜后间隙和胰腺在内的切除边缘均未发现肿瘤细胞。100%接受了远端胰腺次全切除并切除腹腔干及神经解剖的患者获得了完全镇痛效果。接受了远端胰腺次全切除并切除腹腔干的局部晚期胰腺导管癌患者1年和2年生存率分别为59.1%和21.5%，中位生存期为13个月，最长生存期为57个月。
远端胰腺次全切除术联合腹腔干和肝总动脉切除是安全的，具有显著的镇痛效果，可提高可切除性并扩大胰腺切除术的适应证。
