联合腹腔干动脉切除的胰体尾切除术对于局部进展期胰颈/体部癌可获得满意的生存率。

Distal pancreatectomy with celiac artery resection acquires satisfactory survival for locally advanced pancreatic neck/body cancer.

作者信息

Li Min, Shen Rongxi, Wang Sizhen, Zhu Daojun, Wang Xinbo

机构信息

Department of General Surgery, Jinling Hospital, Medicine School of Nanjing University, NO 305 East Zhongshan Road, Nanjing, Jiangsu Province, China.

出版信息

Asian J Surg. 2022 Jan;45(1):137-142. doi: 10.1016/j.asjsur.2021.03.055. Epub 2021 Jun 8.

DOI:10.1016/j.asjsur.2021.03.055

PMID:34116862

Abstract

BACKGROUND

s As a curative surgical procedure for pancreatic neck-body cancer with invasion to celiac artery (CA), the security and efficacy of distal pancreatectomy (DP) with en bloc resection of the celiac artery (DP-CAR) remain controversial. The purpose of this study was to identify the postoperative outcomes of DP-CAR.

METHODS

A retrospectively analysis between January 2010 and January2019 was performed in a single center. 21 patients who underwent DP-CAR and 71 patients who underwent traditional DP for pancreatic neck-body cancer were included. Postoperative morbidity, mortality, overall survival (OS) and disease-free survival (DFS) were evaluated.

RESULTS

There were no significant differences in major complications and mortality between two groups. The patients in DP-CAR group had more T4 tumor (61.9 vs 7.0%, P < 0.001). DP-CAR group had similar R0 resection compared with DP group (71.4% vs 87.3%, P = 0.090). The patients in DP-CAR group suffered more gastric ulcer, DGE and elevated levels of postoperative hepatic enzymes. OS (27.4 vs 32.6 months) and DFS (14.9 vs 19.5 months) between DP-CAR and DP groups were comparative (P = 0.305; P = 0.065).

CONCLUSIONS

For the patients who had pancreatic neck-body cancer with invasion to CA, DP-CAR is safety and could achieve satisfactory R0 resection, OS, and DFS.

摘要

背景

作为一种针对侵犯腹腔干（CA）的胰颈体部癌的根治性手术方法，胰体尾切除术（DP）联合腹腔干整块切除（DP-CAR）的安全性和有效性仍存在争议。本研究的目的是确定DP-CAR的术后结果。

方法

对2010年1月至2019年1月在单一中心进行的回顾性分析。纳入21例行DP-CAR的患者和71例行传统DP治疗胰颈体部癌的患者。评估术后发病率、死亡率、总生存期（OS）和无病生存期（DFS）。

结果

两组在主要并发症和死亡率方面无显著差异。DP-CAR组的T4期肿瘤患者更多（61.9%对7.0%，P<0.001）。与DP组相比，DP-CAR组的R0切除率相似（71.4%对87.3%，P=0.090）。DP-CAR组的患者胃溃疡、胃排空延迟和术后肝酶水平升高的情况更多。DP-CAR组和DP组之间的OS（27.4个月对32.6个月）和DFS（14.9个月对19.5个月）具有可比性（P=0.305；P=0.065）。