Di Carlo V, Zerbi A, Balzano G, Calori G
Cattedra di Chirurgia Generale, Università degli Studi di Milano, San Raffaele.
Chir Ital. 1994;46(2):51-8.
The period 1981-1993, 124 patients underwent resection for pancreatic cancer; they represented 30.8% of all patients observed in that period. Surgical procedures were a pancreatoduodenectomy (PD) in 100 cases, a total pancreatectomy (TP) in 3 cases and a distal pancreatectomy in 21 cases. PD was performed by the injection of Neoprene into the residual pancreatic stump, rather than of pancreatojejunal anastomosis; in 37 cases a pylorus-preserving PD was performed. Adjuvant treatments were given in addition to resection in 75 patients: 47 underwent intraoperative radiation therapy, following a PD in 41 cases, a TP in 1 case and a distal pancreatectomy in 5 cases. Overall operative mortality was 2.4%, overall morbidity 26.6%. In the 103 patients undergoing PD or TP mortality was 2.9% and morbidity 29.1%. Postoperative diabetes occurred in 12.8% of patients undergoing PD with Neoprene injection. Overall median survival was 16 months. Survival was significantly related to UICC staging distribution, to the radical nature of the operation or to adjuvant treatments. No relationship was found between survival and the type of resection (PD versus distal pancreatectomy) or the pylorus preservation. Pancreatic resection, whenever technically possible, represents the treatment of choice of localised pancreatic cancer, in association with adjuvant treatments.
1981年至1993年期间，124例患者接受了胰腺癌切除术；他们占该时期观察到的所有患者的30.8%。手术方式包括100例行胰十二指肠切除术（PD），3例行全胰切除术（TP），21例行胰体尾切除术。PD采用向残留胰残端注射氯丁橡胶而非胰空肠吻合术；37例行保留幽门的PD。75例患者在切除术后接受了辅助治疗：47例接受了术中放疗，其中41例在PD后进行，1例在TP后进行，5例在胰体尾切除术后进行。总体手术死亡率为2.4%，总体发病率为26.6%。在103例行PD或TP的患者中，死亡率为2.9%，发病率为29.1%。接受注射氯丁橡胶的PD患者中，12.8%发生了术后糖尿病。总体中位生存期为16个月。生存期与国际抗癌联盟（UICC）分期分布、手术的根治性或辅助治疗显著相关。未发现生存期与切除类型（PD与胰体尾切除术）或幽门保留之间存在关联。只要技术上可行，胰腺切除术联合辅助治疗是局限性胰腺癌的首选治疗方法。
