浅谈联合动脉切除的胰腺癌根治术的进展

Recent advances in radical resection combined with arterial resection in pancreatic cancer

胰腺癌(pancreatic cancer,PC)是一种恶性程度极高的消化道肿瘤,预后极差,5年生存率不到8%.由于早期常侵犯周围重要血管,多数PC患者失去手术的机会,而R0切除是PC根治性手术的最为重要标准.近些年,联合门静脉/肠系膜上静脉切除的PC根治术的临床应用,使得局部进展期PC患者的生存期有了明显改善.因此,很多学者在探讨联合动脉切除的PC根治术能否累及动脉的局部进展期胰腺患者获益.在此,我们综述了近些年联合动脉切除的PC根治术的最新进展,结果表明联合动脉切除的PC根治术已不是手术的绝对禁忌,对于精选过的局部进展期PC患者,为了达到根治性R0切除而联合动脉切除重建者,可获得较为良好的临床疗效.

Pancreatic cancer(PC)is a highly malignant tumor of the digestive tract,with a very poor prognosis and a 5-year survival rate of less than 8%.Most patients with PC have lost the chance of surgery at diagnosis because of the early invasion of important peripheral blood vessels,although R0 resection is the most important standard of radical surgery for PC.In recent years,the clinical application of pancreatectomy combined with portal vein/superior mesenteric vein resection has significantly improved the survival of patients with locally advanced PC.Therefore,many scholars are investigating whether pancreatectomy combined with arterial resection can benefit patients with locally advanced PC.Here,we review the recent progress regarding the treatment of PC using pancreatectomy combined with artery resection.Artery resection is not an absolute taboo for radical surgery in PC,and in selected patients with locally advanced PC,radical R0 resection and joint artery resection could achieve a relatively good clinical effect.