Wang Xingru, Yang Ya, Li Jianwei, Sun Pijiang
Institute of Hepatobiliary Surgery of the Army, Southwest Hospital, Army Medical University, Chongqing, China.
Gastroenterology Department, Qujing First People's Hospital (Qujing Central Hospital of Yunnan Regional Medical Center), Qujing, China.
Ann Surg Oncol. 2025 Mar;32(3):1898-1901. doi: 10.1245/s10434-024-16739-y. Epub 2024 Dec 25.
Laparoscopic radical antegrade modular pancreatosplenectomy combined with celiac axis resection and portal vein reconstruction is a new procedure for the treatment of pancreatic cancer. This surgical technique may offer patients with pancreatic cancer involving the portal vein and celiac axis an opportunity for radical surgical resection. We aim to evaluate the short- and long-term efficacy and describe the surgical details of this technique.
A 74-year-old man was diagnosed with pancreatic neck-body cancer, with a tumor size of 2.5 × 2.0 × 1.5 cm and local vascular invasion of the celiac axis, common hepatic artery, and portal vein. After four cycles of modified neoadjuvant folinic acid, fluorouracil, oxaliplatin, and irinotecan (FOLFIRINOX) therapy, reevaluation showed that the tumor size had considerably reduced, and the surrounding enlarged lymph nodes disappeared. Laparoscopic radical antegrade modular pancreatosplenectomy, combined with celiac axis resection and portal vein reconstruction, was performed.
The operative time was 300 min, with blood loss of 200 mL. The drainage tube was removed 5 days postoperatively, and the patient was discharged 9 days later. The patient received eight cycles of modified FOLFIRINOX chemotherapy over the following month. After 15 months of follow-up, no tumor recurrence or metastasis was observed.
Laparoscopic radical antegrade modular pancreatosplenectomy, combined with celiac axis resection and portal vein reconstruction, is a safe and effective treatment option for patients with pancreatic neck-body cancer involving the celiac axis and portal vein.
腹腔镜根治性顺行模块化胰脾切除术联合腹腔干切除术和门静脉重建术是一种治疗胰腺癌的新手术方法。这种手术技术可能为累及门静脉和腹腔干的胰腺癌患者提供根治性手术切除的机会。我们旨在评估该技术的短期和长期疗效，并描述该技术的手术细节。
一名74岁男性被诊断为胰颈体部癌，肿瘤大小为2.5×2.0×1.5 cm，局部侵犯腹腔干、肝总动脉和门静脉。在接受四个周期的改良新辅助亚叶酸、氟尿嘧啶、奥沙利铂和伊立替康（FOLFIRINOX）治疗后，重新评估显示肿瘤大小显著缩小，周围肿大的淋巴结消失。遂行腹腔镜根治性顺行模块化胰脾切除术，联合腹腔干切除术和门静脉重建术。
手术时间为300分钟，失血200毫升。术后5天拔除引流管，9天后患者出院。患者在接下来的一个月内接受了八个周期的改良FOLFIRINOX化疗。随访15个月后，未观察到肿瘤复发或转移。
腹腔镜根治性顺行模块化胰脾切除术联合腹腔干切除术和门静脉重建术是治疗累及腹腔干和门静脉的胰颈体部癌患者的一种安全有效的治疗选择。
