胰十二指肠切除术联合肠系膜上动脉整块切除治疗交界可切除胰腺癌——病例报告及文献综述
Pancreatoduodenectomy En Bloc With Superior Mesenteric Artery Resection for Borderline Resectable Pancreatic Cancer - A Case Report and Literature Review.
作者信息
Petrea Sorin, Bacalbasa Nicolae, Balescu Irina, Diaconu Camelia, Stiru Ovidiu, Cauni Victor
机构信息
Department of Visceral Surgery, "Dr. I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
Department of Visceral Surgery, Center of Excellence in Translational Medicine "Fundeni" Clinical Institute, Bucharest, Romania.
出版信息
Cancer Diagn Progn. 2023 Jan 3;3(1):135-138. doi: 10.21873/cdp.10191. eCollection 2023 Jan-Feb.
BACKGROUND/AIM: Pancreatic head adenocarcinoma represents the most aggressive digestive malignancy, which affects patients worldwide and is associated with poor outcomes especially due to the fact that most cases are diagnosed when local vascular invasion is already present.
CASE REPORT
This is a case report of a 44-year-old patient diagnosed with a borderline resectable pancreatic head adenocarcinoma invading the superior mesenteric artery. The patient was submitted to surgery, and intraoperatively the mesenteric artery invasion was found. A pancreatoduodenectomy en bloc with superior mesenteric artery resection was performed while the continuity of the arterial structure was re-established by placing a cadaveric graft.
CONCLUSION
In selected cases, extended arterial resections might be needed in order to achieve negative resection margins and therefore, to improve the chances of long-term survival.
背景/目的：胰头腺癌是最具侵袭性的消化系统恶性肿瘤，全球范围内均有患者受其影响，且预后较差，特别是因为大多数病例在局部血管侵犯已经出现时才被诊断出来。
病例报告
本文报告一例44岁患者，诊断为侵犯肠系膜上动脉的交界可切除胰头腺癌。患者接受了手术，术中发现肠系膜动脉侵犯。实施了胰十二指肠整块切除并切除肠系膜上动脉，同时通过植入尸体移植物重建动脉结构的连续性。
结论
在某些特定病例中，可能需要进行扩大动脉切除，以实现切缘阴性，从而提高长期生存的机会。
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