Feng Pei, Cheng Bo, Wang Zhen-Dong, Liu Jun-Gui, Fan Wei, Liu Heng, Qi Chao-Ying, Pan Jing-Jing
Department of Radiology, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China.
Department of Pathology, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China.
World J Gastrointest Surg. 2021 Nov 27;13(11):1315-1326. doi: 10.4240/wjgs.v13.i11.1315.
Pancreatic head carcinoma (PHC) is one of the common gastrointestinal malignancies with a high morbidity and poor prognosis. At present, radical surgery is still the curative treatment for PHC. However, in clinical practice, the actual R0 resection rate, the local recurrence rate, and the prognosis of PHC are unsatisfactory. Therefore, the concept of total mesopancreas excision (TMpE) is proposed to achieve R0 resection. Although there have various controversies and discussions on the definition, the range of excision, and clinical prognosis of TMpE, the concept of TMpE can effectively increase the R0 resection rate, reduce the local recurrence rate, and improve the prognosis of PHC. Imaging is of importance in preoperative examination for PHC; however, traditional imaging assessment of PHC does not focus on mesopancreas. This review discusses the application of medical imaging in TMpE for PHC, to provide more accurate preoperative evaluation, range of excision, and more valuable postoperative follow-up evaluation for TMpE through imaging. It is believed that with further extensive research and exploratory application of TMpE for PHC, large-sample and multicenter studies will be realized, thus providing reliable evidence for imaging evaluation.
胰头癌（PHC）是常见的胃肠道恶性肿瘤之一，发病率高且预后较差。目前，根治性手术仍是PHC的治愈性治疗方法。然而，在临床实践中，PHC的实际R0切除率、局部复发率和预后并不理想。因此，提出了全胰系膜切除术（TMpE）的概念以实现R0切除。尽管关于TMpE的定义、切除范围和临床预后存在各种争议和讨论，但TMpE的概念可有效提高R0切除率，降低局部复发率，并改善PHC的预后。影像学在PHC的术前检查中具有重要意义；然而，传统的PHC影像学评估并不关注胰系膜。本文综述了医学影像学在PHC的TMpE中的应用，旨在通过影像学为TMpE提供更准确的术前评估、切除范围以及更有价值的术后随访评估。相信随着PHC的TMpE进一步广泛研究和探索性应用，将实现大样本和多中心研究，从而为影像学评估提供可靠依据。
