Jabłońska Beata, Król Robert, Mrowiec Sławomir
Department of Digestive Tract Surgery, Medical University of Silesia, 40-752 Katowice, Poland.
Department of General, Vascular and Transplant Surgery, Medical University of Silesia, 40-027 Katowice, Poland.
Cancers (Basel). 2022 Feb 25;14(5):1193. doi: 10.3390/cancers14051193.
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease with poor prognosis and increased incidence. Surgical resection R0 remains the most important treatment to prolong survival in PDAC patients. In borderline and locally advanced cancer, vascular resection and reconstruction during pancreatectomy enables achieving R0 resection. This study is a comprehensive review of the literature regarding the role of venous and arterial resection with vascular reconstruction in the treatment of pancreatic cancer. The literature review is focused on the use of venous and arterial resection with immediate vascular reconstruction in pancreaticoduodenectomy. Different types of venous and arterial resections are widely described. Different methods of vascular reconstructions, from primary vessel closure, through end-to-end vascular anastomosis, to interposition grafts with use autologous veins (internal jugular vein, saphenous vein, superficial femoral vein, external or internal iliac veins, inferior mesenteric vein, and left renal vein or gonadal vein), autologous substitute grafts constructed from various parts of parietal peritoneum including falciform ligament, cryopreserved and synthetic allografts. The most attention was given to the most common venous reconstructions, such as end-to-end anastomosis and interposition graft with the use of an autologous vein. Moreover, we presented mortality and morbidity rates as well as vascular patency and survival following pancreatectomy combined with vascular resection reported in cited articles.
胰腺导管腺癌（PDAC）是一种预后较差且发病率不断上升的致命疾病。手术R0切除仍然是延长PDAC患者生存期的最重要治疗方法。在临界和局部晚期癌症中，胰腺切除术中的血管切除和重建能够实现R0切除。本研究是对有关静脉和动脉切除并进行血管重建在胰腺癌治疗中作用的文献的全面综述。文献综述聚焦于在胰十二指肠切除术中进行即刻血管重建的静脉和动脉切除的应用。广泛描述了不同类型的静脉和动脉切除。不同的血管重建方法，从血管端端吻合，到使用自体静脉（颈内静脉、大隐静脉、股浅静脉、髂外或髂内静脉、肠系膜下静脉以及左肾静脉或生殖静脉）进行血管间置移植、用包括镰状韧带在内的壁层腹膜各部分构建的自体替代移植物、冷冻保存的同种异体移植物和合成移植物。最受关注的是最常见的静脉重建，如端端吻合和使用自体静脉进行血管间置移植。此外，我们还列出了引用文章中报道的胰十二指肠切除术联合血管切除后的死亡率和发病率，以及血管通畅情况和生存率。
