Experience in Radical Excision of Carcinoma of Head of Pancreas （Report of 55 Cases）_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Bei ¹

Department of Hepatobiliary and Pancreatic Surgery, The First Clinical Hospital, Harbin Medical University, Harbin 150001, China;

Corresponding author：

Keywords：

Radical excision of carcinoma of head of pancreasOperation

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

【Abstract】　Objective　To summarize the experience in radical excision of carcinoma of head of pancreas in order to improve the surgical skills and reduce the occurrence of postoperative complications. Methods　The clinical material of 55 patients (ages: 32-72 years; mean age: 56.5 years) with carcinoma of head of pancreas who received radical excision from January 1996 to March 2005 were analyzed retrospectively. All the cases were pathologically verified as ductal adenocarcinoma of head of pancreas. The treatment time following the operations was divided into two phases by year 2002 ( phaseⅠ: 1996-2002; phaseⅡ: 2002-2005). Different surgical treatment groups were fixed and ICU and other measures were implemented during the second phase. Results　All the patients, consisting of 31 males and 24 females, underwent consecutive extended resection. The radically curative rates of phaseⅠand phaseⅡ were 25.9%(29/112) and 34.7%(26/75), respectively, and the complication rates were 48.3%（14/29） and 19.2%（5/26）, respectively. A variety of surgical skills would improve the operation, including extended regional lymphadenectomy, resection of involved nerve plexus, combined vessel resection and comprehensive bleeding-control technique and so on. Conclusion　The improvement of radically curative effect and the reduction of complication rate depend on the advancement of surgical skills and the further understanding of pathophysiology of carcinoma of head of pancreas.

Citation： SUN Bei,JIANG Hongchi,LU Zhaoyang,WANG Fengjun,MENG Qinghui,TAN Hongtao,XU Jun,LIU Jie,WU Linfeng,PIAO Daxun.. Experience in Radical Excision of Carcinoma of Head of Pancreas （Report of 55 Cases）. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(5): 511-514. doi: Copy

1.	Delcore R, Rodriguez FJ, Forster J, et al. Significance of lymph node metastases in patients with pancreatic cancer undergoing curative resection [Ｊ]. Am J Surg, 1996; 172(5)∶463.
2.	Nagakawa T, Kobayashi H, Ueno K, et al. Clinical study of lymphatic flow to the paraaortic lymph nodes in carcinoma of the head of the pancreas [Ｊ]. Cancer, 1994; 73(4)∶1155.
3.	丁　锐，倪泉兴，张延龄. 胰腺癌的淋巴转移 [Ｊ]. 国外医学·外科学分册, 2001; 28（3）∶140.
4.	Hirai I, Kimura W, Ozawa K, et al. Perineural invasion in pancreatic cancer [Ｊ]. Pancreas, 2002; 24(1)∶15.
5.	Dang C, Qin Z, Ji Z, et al. Morphological characteristics and clinical significance of nerve distribution in pancreatic cancers [Ｊ]. Nippon Ika Daigaku Zasshi, 1997; 64(6)∶526.
6.	Takahashi S, Hasebe T, Oda T, et al. Extra-tumor perineural invasion predicts postoperative development of peritoneal dissemination in pancreatic ductal adenocarcinoma [Ｊ].Anticancer Res, 2001; 21(2B)∶ 1407.
7.	Kenmotsu M, Gochi A, Ishii H, et al. Relationship between perineural invasion and local recurrence of rectal carcinoma: a preliminary study with immunohistochemical staining with anti-NCAM: preliminary report [Ｊ]. Nippon Geta Gakkai Zasshi, 1990; 91(11)∶1759.
8.	Kawahara E, Okada Y, Nakanishi I, et al. The expression of invasive behavior of differentiated squamous carcinoma cell line evaluated by an in vitro invasion model [Ｊ]. Jpn J Cancer Res, 1993; 84(4)∶409.
9.	Yamanaka Y, Friess H, Buchler M, et al. Overexpression of acidic and basic fibroblast growth factors in human pancreatic cancer correlates with advanced tumor stage [Ｊ]. Cancer Res, 1993; 53(21)∶5289.
10.	Bockman DE, Buchler M, Beger HG. Interaction of pancreatic ductal carcinoma with nerves leads to nerve damage [Ｊ]. Gastroenterology, 1994; 107(1)∶219.
11.	Suwa H, Hosotani R, Kogire M, et al. Detection of extrapancreatic nerve plexus invasion of pancreatic adenocarcinoma. Cytokeratin 19 staining and K-ras mutation [Ｊ]. Int J Pancreatol, 1999; 26(3)∶155.
12.	Bachellier P, Nakano H, Oussoultzoglou PD, et al. Is pancreaticoduodenectomy with mesentericoportal venous resection safe and worthwhile? [Ｊ]. Am J Surg, 2001; 182(2)∶120.
13.	代文杰，姜洪池. 综合无血术野技术 [Ｊ]. 哈尔滨医科大学学报， 2000; 34（4）∶311.
14.	Martignoni ME, Wagner M, Krahenbuhl L, et al. Effect of preoperative biliary drainage on surgical outcome after pancreatoduodenectomy [Ｊ]. Am J Surg, 2001; 181(1)∶52.
15.	沈　魁，钟守先，张圣道主编. 胰腺外科 [M]. 北京：人民卫生出版社， 2001∶264~266.

1. 　Delcore R, Rodriguez FJ, Forster J, et al. Significance of lymph node metastases in patients with pancreatic cancer undergoing curative resection [Ｊ]. Am J Surg, 1996; 172(5)∶463.
2. 　Nagakawa T, Kobayashi H, Ueno K, et al. Clinical study of lymphatic flow to the paraaortic lymph nodes in carcinoma of the head of the pancreas [Ｊ]. Cancer, 1994; 73(4)∶1155.
3. 　丁　锐，倪泉兴，张延龄. 胰腺癌的淋巴转移 [Ｊ]. 国外医学·外科学分册, 2001; 28（3）∶140.
4. 　Hirai I, Kimura W, Ozawa K, et al. Perineural invasion in pancreatic cancer [Ｊ]. Pancreas, 2002; 24(1)∶15.
5. 　Dang C, Qin Z, Ji Z, et al. Morphological characteristics and clinical significance of nerve distribution in pancreatic cancers [Ｊ]. Nippon Ika Daigaku Zasshi, 1997; 64(6)∶526.
6. 　Takahashi S, Hasebe T, Oda T, et al. Extra-tumor perineural invasion predicts postoperative development of peritoneal dissemination in pancreatic ductal adenocarcinoma [Ｊ].Anticancer Res, 2001; 21(2B)∶ 1407.
7. 　Kenmotsu M, Gochi A, Ishii H, et al. Relationship between perineural invasion and local recurrence of rectal carcinoma: a preliminary study with immunohistochemical staining with anti-NCAM: preliminary report [Ｊ]. Nippon Geta Gakkai Zasshi, 1990; 91(11)∶1759.
8. 　Kawahara E, Okada Y, Nakanishi I, et al. The expression of invasive behavior of differentiated squamous carcinoma cell line evaluated by an in vitro invasion model [Ｊ]. Jpn J Cancer Res, 1993; 84(4)∶409.
9. 　Yamanaka Y, Friess H, Buchler M, et al. Overexpression of acidic and basic fibroblast growth factors in human pancreatic cancer correlates with advanced tumor stage [Ｊ]. Cancer Res, 1993; 53(21)∶5289.
10. 　Bockman DE, Buchler M, Beger HG. Interaction of pancreatic ductal carcinoma with nerves leads to nerve damage [Ｊ]. Gastroenterology, 1994; 107(1)∶219.
11. 　Suwa H, Hosotani R, Kogire M, et al. Detection of extrapancreatic nerve plexus invasion of pancreatic adenocarcinoma. Cytokeratin 19 staining and K-ras mutation [Ｊ]. Int J Pancreatol, 1999; 26(3)∶155.
12. 　Bachellier P, Nakano H, Oussoultzoglou PD, et al. Is pancreaticoduodenectomy with mesentericoportal venous resection safe and worthwhile? [Ｊ]. Am J Surg, 2001; 182(2)∶120.
13. 　代文杰，姜洪池. 综合无血术野技术 [Ｊ]. 哈尔滨医科大学学报， 2000; 34（4）∶311.
14. 　Martignoni ME, Wagner M, Krahenbuhl L, et al. Effect of preoperative biliary drainage on surgical outcome after pancreatoduodenectomy [Ｊ]. Am J Surg, 2001; 181(1)∶52.
15. 　沈　魁，钟守先，张圣道主编. 胰腺外科 [M]. 北京：人民卫生出版社， 2001∶264~266.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience in Radical Excision of Carcinoma of Head of Pancreas （Report of 55 Cases）

Abstract Full text Figures/Tables Video References Cited by

Format

Content