Surgical treatment of pancreatic cancer

作者：Wioletta Masiak-Segit, Karol Rawicz‐Pruszyński, Magdalena Skórzewska, Wojciech Piotr Polkowski · 发表于：Polish Journal of Surgery · 年份：2018 · DOI：10.5604/01.3001.0011.7493 · 被引用次数：60 · 研究领域：Pancreatic and Hepatic Oncology Research、Cancer Genomics and Diagnostics、Neuroendocrine Tumor Research Advances

The only way to cure the patient with adenocarcinoma of the pancreas (RT) is surgical excision of the tumor. The standard surgical treatment of resectable pancreatic carcinoma is considered the classic pancreatoduodenectomy (PD) with the Kausch- Whipple procedure, or the pylorus-preserving PD with the Traverso-Longmire method. The most difficult technically and at the same time the most important PD stage from an oncological point of view is the separation of the head of the pancreas from the superior mesenteric artery. Over the last decades several PD modifications have been developed, focusing on this maneuver in the early phase of the operation, i.e. before the pancreas is cut (an irreversible stage of the procedure). These procedures in the English literature are called "artery-first approach" or "SMA-first approach". The term "mesopancreas" was created. Complete removal of the mesopancreas together with the proximal part of the jejunum is considered an R0 resection in the case of a tumor of the head of the pancreas with direct or indirect vascular invasion, or metastases to regional lymph nodes, and in English literature it is referred to as pancreatoduodenectomy with systematic mesopancreas dissection (SMDPD). Distal resection of the pancreas (DRT) due to cancer, is associated with a high percentage of positive margins, insufficient number of removed lymph nodes, low survival rates. A new technique was developed - a radical proximal-distal modular pancreatosplenectomy (...