联合门静脉-肠系膜上静脉切除的胰腺癌根治术

Portal and superior mesenteric vein resection in radical pancreatectomy for pancreatic cancer

根治性切除仍是胰腺癌患者长期生存甚至获得治愈的关键。但仅有小部分患者具有根治性切除的机会，部分患者则因门静脉．肠系膜上静脉受侵犯而被界定为可能切除或局部进展期胰腺癌。联合静脉切除使门静脉一肠系膜上静脉受侵犯患者获得根治性切除机会。笔者就静脉侵犯术前评估、切除重建分型、血管植入物选择、术后并发症的防治及远期疗效等方面进行初步探讨。

Radical resection remains essential for pro- longing survival and increasing the possibility of cure in pancre- atic cancer. However, few patients are resectable at the time of diagnosis, with a portion of patients presenting with portal and superior mesenterie vein invasion and regarded as reseetable or locally advanced disease. Venous resection in pancreatectomy enables achievement of tumor-free margins in patients with ve- nous invasion. This review provides an overview of preoperative evaluation, resection and reconstruction types, vascular grafts selection, morbidity, mortality and survival in radical pancreate- ctomy with portal and superior mesenteric vein resection.