联合血管切除重建的胰腺癌根治性手术

Radical resection of pancreatic cancer combined with vascu-lar resection and reconstruction

胰腺是腹膜后器官，解剖位置特殊。胰腺癌的生物学特性决定其容易侵犯腹腔淋巴结及周围的大血管。这导致胰腺癌切除困难，切除率仅为10％～20％，并且，临床上因腹腔大血管受累而未能切除的胰腺癌高达30％～40％。尽管胰腺癌患者术后5年生存率〈5％，手术依然是目前胰腺癌的首选治疗手段。如何提高胰腺癌的手术切除率和改善患者预后，是当前胰腺外科领域一个亟待解决的难题。

Most of the pancreatic cancer was diagnosed at advanced stages and the resection rate was only 10%-20%. Vascular invasion was a common event in the pathogenesis of pancreatic cancer. However, in the traditional view, vascular invasion is a contraindication of pancreatic resection. With the development of surgical techniques and perioperative manage- ment, radical resection of pancreatic cancer with vascular resec- tion and reconstruction was performed in some large centers. Preliminary results suggested that this procedure could increase the resection rate and 5-year survival to 26%-46% and 20% respectively, without increasing morbidity and mortality. Radical resection of pancreatic cancer with vascular resection and recon- struction was a safe and effective method for the surgical treat-ment of advanced pancreatic cancer, which should be performed by experienced pancreatic surgeons.