"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
"I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
In Vivo. 2019 Nov-Dec;33(6):2303-2308. doi: 10.21873/invivo.11738.
BACKGROUND/AIM: Pancreatic cancer remains asymptomatic for a long period of time, being frequently diagnosed when vascular invasion is already present. Such cases are widely known as borderline lesions. The aim of this study was to identify the effectiveness of vascular resection in this subgroup of patients.
Fifteen such cases were submitted to surgery with curative intent.
Eight cases were diagnosed with borderline resectable lesions with portal vein invasion and were submitted to per primam resection and seven cases were initially diagnosed with arterial invasion and had been initially submitted to neoadjuvant chemotherapy followed by resection. In all cases portal vein resection was needed while in other four cases association of superior mesenteric artery resection was performed. Postoperatively, five patients developed complications requiring reoperation, three of whom died at the end of the first postoperative month. The histopathological studies confirmed the completeness of resection in all cases.
Vascular resections in pancreatic cancer resections remain demanding procedures, and are reserved for cases in which a radical resection is feasible.
背景/目的：胰腺癌在很长一段时间内都没有症状，当已经存在血管侵犯时，通常才被诊断出来。这种情况通常被称为边界病变。本研究的目的是确定血管切除在这组患者中的有效性。
15 例有此边界可切除病变且门静脉受侵的患者接受了以治愈为目的的手术。
8 例诊断为边界可切除性病变伴门静脉侵犯，并接受了原发切除，7 例最初诊断为动脉侵犯，先接受新辅助化疗，然后再进行切除。所有病例均需要门静脉切除，另外 4 例则需要联合肠系膜上动脉切除。术后，5 例患者发生并发症需要再次手术，其中 3 例在术后第一个月死亡。组织病理学研究证实了所有病例的切除完全性。
在胰腺癌切除术中，血管切除仍然是一项要求很高的手术，仅适用于可行根治性切除的病例。
