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Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer
BACKGROUND: This study aims to observe and analyze the clinical efficacy of the pancreaticoduodenectomy (PD) with total mesopancreas excision (TMpE) via the artery approach for carcinoma of head of the pancreas. METHODS: From October 2015 to October 2016, 60 patients with pancreatic head cancer were...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785284/ https://www.ncbi.nlm.nih.gov/pubmed/31636776 http://dx.doi.org/10.14740/gr1225 |
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author | Du, Futian Wang, Xin Lin, Hongfeng Zhao, Xuelin |
author_facet | Du, Futian Wang, Xin Lin, Hongfeng Zhao, Xuelin |
author_sort | Du, Futian |
collection | PubMed |
description | BACKGROUND: This study aims to observe and analyze the clinical efficacy of the pancreaticoduodenectomy (PD) with total mesopancreas excision (TMpE) via the artery approach for carcinoma of head of the pancreas. METHODS: From October 2015 to October 2016, 60 patients with pancreatic head cancer were enrolled in this study. Twenty-eight patients were treated with PD with TMpE via the artery approach (group A), while 32 patients were treated with PD alone (group B) in our hospital. The clinical data of the patients were retrospectively collected, including intra-operative evaluation index, R0 resection rate of postoperative pathological specimens, postoperative complications, and the tumor recurrence time was observed after operation (at third, sixth, and 12th months). Clinical efficacy of PD with TMpE via the artery approach was evaluated between the two groups. RESULTS: There was no significant difference in the operation time or perioperative death between the two groups (P > 0.05). Postoperative specimen pathology showed that there was a statistically significant difference in the R0 resection rate between the two groups (P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P > 0.05). Tumor recurrence rate at month 3 post operation was 0 (0/28) in group A and 3.13% (1/32) in group B. There was no significant difference in the 6-month recurrence rate (P > 0.05). Postoperative recurrence rate in group A was significantly lower than that in group B at month 12 (P < 0.05). CONCLUSIONS: The PD with TMpE via the artery approach treatment of pancreatic head cancer can reduce the amount of intra-operative bleeding and save the operation time without increasing postoperative complications. It provides effective technical support for combined vascular anastomosis in the treatment of pancreatic head cancer with venous system invasion, and ensures the safety of operation. Moreover, this procedure can improve the R0 resection rate and reduce the recurrence rate in the near future. As a safe, effective and feasible surgical method for the treatment of pancreatic head cancer, it can be widely used in clinical practice. |
format | Online Article Text |
id | pubmed-6785284 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-67852842019-10-21 Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer Du, Futian Wang, Xin Lin, Hongfeng Zhao, Xuelin Gastroenterology Res Original Article BACKGROUND: This study aims to observe and analyze the clinical efficacy of the pancreaticoduodenectomy (PD) with total mesopancreas excision (TMpE) via the artery approach for carcinoma of head of the pancreas. METHODS: From October 2015 to October 2016, 60 patients with pancreatic head cancer were enrolled in this study. Twenty-eight patients were treated with PD with TMpE via the artery approach (group A), while 32 patients were treated with PD alone (group B) in our hospital. The clinical data of the patients were retrospectively collected, including intra-operative evaluation index, R0 resection rate of postoperative pathological specimens, postoperative complications, and the tumor recurrence time was observed after operation (at third, sixth, and 12th months). Clinical efficacy of PD with TMpE via the artery approach was evaluated between the two groups. RESULTS: There was no significant difference in the operation time or perioperative death between the two groups (P > 0.05). Postoperative specimen pathology showed that there was a statistically significant difference in the R0 resection rate between the two groups (P < 0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P > 0.05). Tumor recurrence rate at month 3 post operation was 0 (0/28) in group A and 3.13% (1/32) in group B. There was no significant difference in the 6-month recurrence rate (P > 0.05). Postoperative recurrence rate in group A was significantly lower than that in group B at month 12 (P < 0.05). CONCLUSIONS: The PD with TMpE via the artery approach treatment of pancreatic head cancer can reduce the amount of intra-operative bleeding and save the operation time without increasing postoperative complications. It provides effective technical support for combined vascular anastomosis in the treatment of pancreatic head cancer with venous system invasion, and ensures the safety of operation. Moreover, this procedure can improve the R0 resection rate and reduce the recurrence rate in the near future. As a safe, effective and feasible surgical method for the treatment of pancreatic head cancer, it can be widely used in clinical practice. Elmer Press 2019-10 2019-10-04 /pmc/articles/PMC6785284/ /pubmed/31636776 http://dx.doi.org/10.14740/gr1225 Text en Copyright 2019, Du et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Du, Futian Wang, Xin Lin, Hongfeng Zhao, Xuelin Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer |
title | Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer |
title_full | Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer |
title_fullStr | Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer |
title_full_unstemmed | Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer |
title_short | Pancreaticoduodenectomy With Arterial Approach of Total Mesenteric Resection of the Pancreas for Pancreatic Head Cancer |
title_sort | pancreaticoduodenectomy with arterial approach of total mesenteric resection of the pancreas for pancreatic head cancer |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785284/ https://www.ncbi.nlm.nih.gov/pubmed/31636776 http://dx.doi.org/10.14740/gr1225 |
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