Nakajima Karin, Maruyama Tomohiro, Aono Takashi, Suzuki Susumu, Kaneko Kazuhiro, Sato Tomoi, Okada Takayuki, Muto Ichiro, Hasegawa Masaki, Muneoka Yusuke, Tajima Yosuke, Ichikawa Hiroshi, Shimada Yoshifumi, Sakata Jun, Wakai Toshifumi
Dept. of Surgery, Niigata Prefectural Central Hospital.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1681-1683.
A 53-year-old woman underwent subtotal stomach-preserving pancreaticoduodenectomy(SSPPD)for resectable pancreatic cancer after neoadjuvant chemotherapy. Postoperatively, she received hepatic arterial infusion of 5-FU and S-1 chemotherapy. Two years after SSPPD, abdominal computed tomography showed a 2-cm mass in the remnant pancreas, which was diagnosed as recurrence of cancer by endoscopic ultrasound-guided fine-needle aspiration. Staging laparoscopy was performed and peritoneal washing cytology(CY)was positive. She then received gemcitabine plus nab-paclitaxel chemotherapy for 8 months. After that, staging laparoscopy was performed again and negative CY was confirmed. A total remnant pancreatectomy with splenectomy was performed. She received chemotherapy after pancreatectomy and is now alive and well without recurrence 2 years and 1 month after the second surgery. Although positive CY is a poor prognostic factor, surgery combined with perioperative chemotherapy may contribute to prolonged survival for some patients who have recurrence in the remnant pancreas with positive CY.
一名53岁女性在新辅助化疗后接受了保留胃的胰十二指肠次全切除术（SSPPD）以治疗可切除的胰腺癌。术后，她接受了肝动脉灌注5-氟尿嘧啶和S-1化疗。SSPPD术后两年，腹部计算机断层扫描显示残余胰腺有一个2厘米的肿块，经内镜超声引导下细针穿刺活检诊断为癌症复发。进行了分期腹腔镜检查，腹腔冲洗细胞学检查（CY）呈阳性。然后她接受了吉西他滨联合白蛋白结合型紫杉醇化疗8个月。之后再次进行分期腹腔镜检查，确认CY为阴性。进行了全胰切除术加脾切除术。她在胰腺切除术后接受了化疗，现在在第二次手术后2年1个月仍存活且无复发。尽管CY阳性是一个不良预后因素，但手术联合围手术期化疗可能有助于延长一些CY阳性且残余胰腺复发患者的生存期。
