中国实用外科杂志2017，Vol.37Issue(7)：784-787,4.DOI:10.19538/j.cjps.issn1005-2208.2017.07.21
联合腹腔干切除胰体尾癌根治术疗效及安全性分析
Clinical efficacy and safety of distal pancreatectomy with celiac axis resection for pancreatic body/tail cancer
侍力刚 1冀蒙 1陈军 1汤靓 1陈丹磊 1刘安安 1胡先贵 2邵成浩1
作者信息
- 1. 第二军医大学附属长征医院胰胆外科,上海200003
- 2. 第二军医大学附属长海医院,上海200433
- 折叠
摘要
Abstract
Objective To analyze the efficacy and safety of distal pancreatectomy with celiac axis resection for pancreatic body/tail cancer. Methods The clinicopathological data of 126 patients with pancreatic body/tail cancer who underwent distal pancreatectomy with R0 resection and without distant metastasis from 2010 to 2014 in Department of Pancreatic Surgery,Changhai Hospital,the Second Military Medical University were reviewed retrospectively. The same surgical group performed distal pancreatectomy with celiac axis resection(DP-CAR)for 31 patients and standard distal pancreatectomy(DP)for 95 patients. Results Compared with DP group,more patients with pT3-T4 stage in DP-CAR group(85.7% vs. 43.9%,P<0.001),and more patients were borderline resectable pancreatic cancer (BRPC) in DP-CAR group(87.1%vs. 5.3%,P<0.001). The operation time [(134.4±28.6)min vs.(111.8±38.1)min,P=0.004] and postoperative length of hospital stay [(16.2 ± 11.0)d vs.(8.4 ± 2.7)d,P<0.001] were significantly longer in the DP-CAR group. Grade C pancreatic fistulas (19.4% vs. 2.1%,P=0.003) and postoperative hemorrhages(19.4% vs. 3.2%,P=0.007) were significantly more in DP-CAR group. Two patients in DP-CAR group died because of postoperative hemorrhages. The median survival time (MST)after DP-CAR and DP were 19 months and 20 months(P=0.652). Conclusion DP-CAR offers high resection rate for patients with borderline resectable pancreatic body/tail cancer, and postoperative complication rate and morbidity are higher than those in DP. Some patients can benefit from DP-CAR.关键词
腹腔干/胰体尾癌根治术/可能切除胰腺癌/并发症Key words
celiac axis/distal pancreatectomy/borderline resectable pancreatic carcinoma (BRPC)/complication分类
医药卫生引用本文复制引用
侍力刚,冀蒙,陈军,汤靓,陈丹磊,刘安安,胡先贵,邵成浩..联合腹腔干切除胰体尾癌根治术疗效及安全性分析[J].中国实用外科杂志,2017,37(7):784-787,4.
