联合血管切除和重建的FortnerⅠ型和Ⅱ型胰腺癌区域性切除术

Regional radical resection combined with vessel resection and reconstruction (Fortner type Ⅰ、Ⅱ) for the treatment of pancreatic cancer

目的探讨联合切除血管和重建的区域性胰腺癌根治术的临床疗效。方法 对行联合肠系膜上静脉 门静脉 (SMPV)切除的Ⅰ型区域性胰十二指肠切除术、联合SMPV等多根血管切除的Ⅱ型区域性胰十二指肠切除术的 6例胰腺癌作一回顾性分析。结果 1例胰体癌联合切除肠系膜上动脉、肠系膜上静脉和肝动脉行人造血管间置移植术 ,术后存活 13个月死亡 ;5例行标准胰十二指肠切除术 ,联合肠系膜上静脉切除人工血管间置移植术 ,随访 5～ 34个月 ,无复发 ,超声和CT显示移植人造血管通畅。结论在严格选择的病例中可施行联合切除血管的胰腺癌区域根治术。

ObjectiveTo evaluate the effect of regional radical pancraticoduodenectomy (PD) combined with resection and reconstruction of invaded blood vessel (Fortner type Ⅰ?Ⅱ procedure) for pancreatic cancer.MethodsResult of 5 Fortner Ⅰ cases undergoing PD and resection of superior mesenteric-portal vein (SMPV),and 1 FortnerⅡ case with resection of SMPV,superior mesenteric artery(SMA)and hepatic artery(HA) was reviewed. ResultThe case undergoing Fortner Ⅱ surgery survived for 13 months.The 5 Fortner Ⅰ cases were followed-up for 5～34 months,with patent graft as identified by CT and ultrasonography and with no recurrence. ConclusionRegional pancreatectomy combined with resection of invaded blood vessel can be carried out in carefully selected patients of pancreatic cancer with favourable long term-result.