Olakowski Marek, Grudzińska Ewa
Department of Gastrointestinal Surgery, Medical University of Silesia, Medyków 14, 40-752, Katowice, Poland.
Department of Gastrointestinal Surgery, Medical University of Silesia, Medyków 14, 40-752, Katowice, Poland.
Asian J Surg. 2023 Jan;46(1):73-81. doi: 10.1016/j.asjsur.2022.05.117. Epub 2022 Jun 6.
Pancreatic head cancer is a highly fatal disease. For now, surgery offers the only potential long-term cure albeit with a high risk of complications. However, the progress of surgical technique during the past decade has resulted in 5-year survival approaching 30% after resection and adjuvant chemotherapy. This paper presents current data on the recommended extent of lymphadenectomy, the resection margin, on the definition of resectable and borderline resectable tumors and mesopancreas. Surgical techniques proposed to improve PD are presented: the artery first approach, the uncinate process first, the mesopancreas first approach, the triangle operation, periarterial divestment, and multiorgan resection.
胰头癌是一种致死率很高的疾病。目前，手术是唯一有可能实现长期治愈的方法，尽管并发症风险很高。然而，在过去十年中，手术技术的进步使得切除术后接受辅助化疗的患者5年生存率接近30%。本文介绍了关于推荐的淋巴结清扫范围、切缘、可切除和临界可切除肿瘤的定义以及中胰的当前数据。还介绍了为改进胰十二指肠切除术（PD）而提出的手术技术：动脉优先入路、钩突优先入路、中胰优先入路、三角手术、动脉周围剥离术和多器官切除术。
