交界可切除胰頭癌新輔助化療后行聯合靜脈切除重建 LPD 的初步體會_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

徐均 ^1,2 , 孟令威 ^1,2 , 蔡云強 ^1,2 , 李永彬 ^1,2 ,  彭兵 ^1,2

1. ;
2. ;

Corresponding?author：

彭兵, Email: pengbing84@hotmail.com

Keywords：

交界可切除胰腺癌; 腹腔鏡胰十二指腸切除術; 新輔助化療; 血管切除重建

DOI：

10.7507/1007-9424.202107093

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探討交界可切除胰頭癌新輔助化療后行聯合靜脈切除重建的腹腔鏡胰十二指腸切除術（laparoscopic pancreaticoduodenectomy，LPD）的安全性及可行性。方法回顧性收集并分析 2019 年 8 月至 2021 年 1 月期間于四川大學華西醫院上錦分院肝膽胰微創外科實施的 4 例交界可切除胰頭癌新輔助化療后行聯合血管切除重建的 LPD 患者的臨床資料。結果 4 例患者均在完全腹腔鏡下完成手術，手術時間分別為 520、452、375 和 430 min，術中出血量分別為 300、800、150 和 200 mL，術后住院時間分別為 36、20、16 和 16 d。術后 1 例患者出現膽汁漏、行再次引流后好轉出院，1 例出現乳糜漏，導致引流管拔除時間及住院時間延長，其余 2 例未出現并發癥，正常出院。4 例患者術后病理學檢查證實均為胰頭導管腺癌，總生存期分別為 18、12、20 和 11 個月（仍存活）。結論對于高度選擇性的交界可切除胰頭癌新輔助化療后行聯合靜脈切除重建的 LPD 在經驗豐富的大的胰腺中心是安全可行的，但仍需大樣本隨機對照試驗來驗證這一結論。

Citation： 徐均, 孟令威, 蔡云強, 李永彬, 彭兵. 交界可切除胰頭癌新輔助化療后行聯合靜脈切除重建 LPD 的初步體會. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(9): 1144-1147. doi: 10.7507/1007-9424.202107093 Copy

1.	Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin, 2020, 70(1): 7-30.
2.	Viale PH. The American Cancer Society’s facts & figures: 2020 edition. J Adv Pract Oncol, 2020, 11(2): 135-136.
3.	Michelakos T, Pergolini I, Castillo CF, et al. Predictors of resectability and survival in patients with borderline and locally advanced pancreatic cancer who underwent neoadjuvant treatment with FOLFIRINOX. Ann Surg, 2019, 269(4): 733-740.
4.	Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic Adenocarcinoma, Version 2. 2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2021, 19(4): 439-457.
5.	Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer, 2009, 45(2): 228-247.
6.	李永彬, 蔡云強, 王昕, 等. 流程優化的全腹腔鏡胰十二指腸切除術的臨床總結(附手術視頻). 四川大學學報(醫學版), 2020, 51(4): 446-452.
7.	Cai Y, Gao P, Li Y, et al. Laparoscopic pancreaticoduodenectomy with major venous resection and reconstruction: anterior superior mesenteric artery first approach. Surg Endosc, 2018, 32(10): 4209-4215.
8.	Versteijne E, Suker M, Groothuis K, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: results of the dutch randomized phase Ⅲ PREOPANC trial. J Clin Oncol, 2020, 38(16): 1763-1773.
9.	Jang JY, Han Y, Lee H, et al. Oncological benefits of neoadjuvant chemoradiation with gemcitabine versus upfront surgery in patients with borderline resectable pancreatic cancer: A prospective, randomized, open-label, multicenter phase 2/3 trial. Ann Surg, 2018, 268(2): 215-222.
10.	中華醫學會外科學分會胰腺外科學組. 中國胰腺癌診治指南(2021). 中國實用外科雜志, 2021, 41(7): 721-734.
11.	Dhir M, Zenati MS, Hamad A, et al. FOLFIRINOX versus gemcitabine/nab-paclitaxel for neoadjuvant treatment of resectable and borderline resectable pancreatic head adenocarcinoma. Ann Surg Oncol, 2018, 25(7): 1896-1903.
12.	Heger U, Sun H, Hinz U, et al. Induction chemotherapy in pancreatic cancer: CA 19-9 may predict resectability and survival. HPB (Oxford), 2020, 22(2): 224-232.
13.	Cassinotto C, Sa-Cunha A, Trillaud H. Radiological evaluation of response to neoadjuvant treatment in pancreatic cancer. Diagn Interv Imaging, 2016, 97(12): 1225-1232.
14.	Luo G, Liu C, Guo M, et al. Potential biomarkers in lewis negative patients with pancreatic cancer. Ann Surg, 2017, 265(4): 800-805.
15.	Napolitano F, Formisano L, Giardino A, et al. Neoadjuvant treatment in locally advanced pancreatic cancer (lapc) patients with FOLFIRINOX or gemcitabine nabpaclitaxel: A single-center experience and a literature review. Cancers (Basel), 2019, 11(7): 981.
16.	梁廷波, 白雪莉, 李想. 胰腺癌新輔助治療的進展及面臨的問題. 中國普外基礎與臨床雜志, 2017, 24(6): 657-660.
17.	中華醫學會外科學分會胰腺外科學組, 中國研究型醫院學會胰腺疾病專業委員會. 中國胰腺癌新輔助治療指南(2020 版). 協和醫學雜志, 2020, 11(5): 547-558.
18.	Belyaev O, Munding J, Herzog T, et al. Histomorphological features of the pancreatic remnant as independent risk factors for postoperative pancreatic fistula: a matched-pairs analysis. Pancreatology, 2011, 11(5): 516-524.
19.	de Rooij T, Lu MZ, Steen MW, et al. Minimally invasive versus open pancreatoduodenectomy: systematic review and meta-analysis of comparative cohort and registry studies. Ann Surg, 2016, 264(2): 257-267.
20.	Stauffer JA, Coppola A, Villacreses D, et al. Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc, 2017, 31(5): 2233-2241.
21.	Ravikumar R, Sabin C, Abu Hilal M, et al. Impact of portal vein infiltration and type of venous reconstruction in surgery for borderline resectable pancreatic cancer. Br J Surg, 2017, 104(11): 1539-1548.
22.	Croome KP, Farnell MB, Que FG, et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg, 2015, 19(1): 189-194.
23.	Zhiying Y, Haidong T, Xiaolei L, et al. The falciform ligament as a graft for portal-superior mesenteric vein reconstruction in pancreatectomy. J Surg Res, 2017, 218: 226-231.

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin, 2020, 70(1): 7-30.
2. Viale PH. The American Cancer Society’s facts & figures: 2020 edition. J Adv Pract Oncol, 2020, 11(2): 135-136.
3. Michelakos T, Pergolini I, Castillo CF, et al. Predictors of resectability and survival in patients with borderline and locally advanced pancreatic cancer who underwent neoadjuvant treatment with FOLFIRINOX. Ann Surg, 2019, 269(4): 733-740.
4. Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic Adenocarcinoma, Version 2. 2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2021, 19(4): 439-457.
5. Eisenhauer EA, Therasse P, Bogaerts J, et al. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer, 2009, 45(2): 228-247.
6. 李永彬, 蔡云強, 王昕, 等. 流程優化的全腹腔鏡胰十二指腸切除術的臨床總結(附手術視頻). 四川大學學報(醫學版), 2020, 51(4): 446-452.
7. Cai Y, Gao P, Li Y, et al. Laparoscopic pancreaticoduodenectomy with major venous resection and reconstruction: anterior superior mesenteric artery first approach. Surg Endosc, 2018, 32(10): 4209-4215.
8. Versteijne E, Suker M, Groothuis K, et al. Preoperative chemoradiotherapy versus immediate surgery for resectable and borderline resectable pancreatic cancer: results of the dutch randomized phase Ⅲ PREOPANC trial. J Clin Oncol, 2020, 38(16): 1763-1773.
9. Jang JY, Han Y, Lee H, et al. Oncological benefits of neoadjuvant chemoradiation with gemcitabine versus upfront surgery in patients with borderline resectable pancreatic cancer: A prospective, randomized, open-label, multicenter phase 2/3 trial. Ann Surg, 2018, 268(2): 215-222.
10. 中華醫學會外科學分會胰腺外科學組. 中國胰腺癌診治指南(2021). 中國實用外科雜志, 2021, 41(7): 721-734.
11. Dhir M, Zenati MS, Hamad A, et al. FOLFIRINOX versus gemcitabine/nab-paclitaxel for neoadjuvant treatment of resectable and borderline resectable pancreatic head adenocarcinoma. Ann Surg Oncol, 2018, 25(7): 1896-1903.
12. Heger U, Sun H, Hinz U, et al. Induction chemotherapy in pancreatic cancer: CA 19-9 may predict resectability and survival. HPB (Oxford), 2020, 22(2): 224-232.
13. Cassinotto C, Sa-Cunha A, Trillaud H. Radiological evaluation of response to neoadjuvant treatment in pancreatic cancer. Diagn Interv Imaging, 2016, 97(12): 1225-1232.
14. Luo G, Liu C, Guo M, et al. Potential biomarkers in lewis negative patients with pancreatic cancer. Ann Surg, 2017, 265(4): 800-805.
15. Napolitano F, Formisano L, Giardino A, et al. Neoadjuvant treatment in locally advanced pancreatic cancer (lapc) patients with FOLFIRINOX or gemcitabine nabpaclitaxel: A single-center experience and a literature review. Cancers (Basel), 2019, 11(7): 981.
16. 梁廷波, 白雪莉, 李想. 胰腺癌新輔助治療的進展及面臨的問題. 中國普外基礎與臨床雜志, 2017, 24(6): 657-660.
17. 中華醫學會外科學分會胰腺外科學組, 中國研究型醫院學會胰腺疾病專業委員會. 中國胰腺癌新輔助治療指南(2020 版). 協和醫學雜志, 2020, 11(5): 547-558.
18. Belyaev O, Munding J, Herzog T, et al. Histomorphological features of the pancreatic remnant as independent risk factors for postoperative pancreatic fistula: a matched-pairs analysis. Pancreatology, 2011, 11(5): 516-524.
19. de Rooij T, Lu MZ, Steen MW, et al. Minimally invasive versus open pancreatoduodenectomy: systematic review and meta-analysis of comparative cohort and registry studies. Ann Surg, 2016, 264(2): 257-267.
20. Stauffer JA, Coppola A, Villacreses D, et al. Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc, 2017, 31(5): 2233-2241.
21. Ravikumar R, Sabin C, Abu Hilal M, et al. Impact of portal vein infiltration and type of venous reconstruction in surgery for borderline resectable pancreatic cancer. Br J Surg, 2017, 104(11): 1539-1548.
22. Croome KP, Farnell MB, Que FG, et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg, 2015, 19(1): 189-194.
23. Zhiying Y, Haidong T, Xiaolei L, et al. The falciform ligament as a graft for portal-superior mesenteric vein reconstruction in pancreatectomy. J Surg Res, 2017, 218: 226-231.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

交界可切除胰頭癌新輔助化療后行聯合靜脈切除重建 LPD 的初步體會

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content