Kang Chang Moo, Lee Woo Jung
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 03772, Korea.
Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul 03772, Korea.
Cancers (Basel). 2020 Nov 18;12(11):3430. doi: 10.3390/cancers12113430.
Margin-negative radical pancreatectomy is the essential condition to obtain long-term survival of patients with pancreatic cancer. With the investigation for early diagnosis, introduction of potent chemotherapeutic agents, application of neoadjuvnat chemotherapy, advancement of open and laparoscopic surgical techniques, mature perioperative management, and patients' improved general conditions, survival of the resected pancreatic cancer is expected to be further improved. According to the literatures, laparoscopic pancreaticoduodenectomy (LPD) is also thought to be good alternative strategy in managing well-selected resectable pancreatic cancer. LPD with combined vascular resection is also feasible, but only expert surgeons should handle these challenging cases. LPD for pancreatic cancer should be determined based on surgeons' proficiency to fulfil the goals of the patient's safety and oncologic principles.
切缘阴性的根治性全胰切除术是胰腺癌患者获得长期生存的必要条件。随着早期诊断研究的开展、强效化疗药物的引入、新辅助化疗的应用、开放和腹腔镜手术技术的进步、围手术期管理的成熟以及患者一般状况的改善,预计接受手术切除的胰腺癌患者的生存率将进一步提高。根据文献报道,腹腔镜胰十二指肠切除术(LPD)也被认为是治疗精心挑选的可切除胰腺癌的良好替代策略。联合血管切除的LPD也是可行的,但只有经验丰富的外科医生才能处理这些具有挑战性的病例。胰腺癌的LPD应根据外科医生的熟练程度来决定,以实现患者安全和肿瘤学原则的目标。