首页|Ductal adenocarcinoma of the pancreatic head: A focus on current diagnostic and surgical concepts

Ductal adenocarcinoma of the pancreatic head: A focus on current diagnostic and surgical concepts

扫码查看
原文链接
  • NETL
  • NSTL
  • 万方数据
  • 维普
Complete surgical resection still remains the only possibility of curing pancreatic cancer,however,only 10％ of patients undergo curative surgery.Pancreatic resection currently remains the only method of curing patients,and has a 5-year overall survival rate between 7％-34％ compared to a median survival of 3-11 mo for unresected cancer.Pancreatic surgery is a technically demanding procedure requiring highly standardized surgical techniques.Nevertheless,even in experienced hands,perioperative morbidity rates (delayed gastric emptying,pancreatic fistula etc.) are as high as 50％.Different strategies to reduce postoperative morbidity,such as different techniques of gastroenteric reconstruction (pancreatico-jejunostomy vs pancreatico-gastrostomy),intraoperative placement of a pancreatic main duct stent or temporary sealing of the main pancreatic duct with fibrin glue have not led to a significant improvement in clinical outcome.The perioperative application of somatostatin or its analogues may decrease the incidence of pancreatic fistulas in cases with soft pancreatic tissue and a small main pancreatic duct (＜ 3 mm).The positive effects of external pancreatic main duct drainage and antecolic gastrointestinal reconstruction have been observed to decrease the rate of pancreatic fistulas and delayed gastric emptying,respectively.Currently,the concept of extended radical lymphad-enectomy has been found to be associated with higher perioperative morbidity,but without any positive impact on overall survival.However,there is growing evidence that portal vein resections can be performed with acceptable low perioperative morbidity and mortality but does not achieve a cure.

Pancreatic adenocarcinomaPancreatic fistulaPancreatic surgeryVenous resection

Mehdi Oua(i)ssi、Urs Giger、Guillaume Louis、Igor Sielezneff、Olivier Farges、Bernard Sastre

展开 >

Centre for Research in Oncology and Oncopharmacologie, Aix Marseille University, 13005 Marseille, France

Department of Oncologic and Digestive Surgery, Timone Hospital, 13385 Marseille, France

Department of Surgery, Marienhospital Herne, Ruhr University Bochum, 44625 Herne, Germany

Department of Radiology, Timone Hospital,13385 Marseille, France

Department of Hepato-Biliary Surgery, Beaujon Hospital, 92110 Clichy, France

展开 >

2012

10.3748/wjg.v18.i24.3058

世界胃肠病学杂志(英文版)
太原消化病研治中心

世界胃肠病学杂志(英文版)

SCI
影响因子：1.001
ISSN：1007-9327
年,卷(期)：2012.18(24)
  • 6
  • 105