侵犯大血管的胰腺神经内分泌肿瘤外科治疗

Surgical treatment of pancreatic neuroendocrine neoplasms with major vascular resection

胰腺神经内分泌肿瘤的预后明显好于胰腺癌,局部进展期的胰腺神经内分泌肿瘤可侵犯肠系膜上静脉、门静脉、肠系膜上动脉、腹腔干等胰腺周围大血管。术前需进行全面的检查,对肿瘤的可切除性和生物学特性进行评估和判断,选择合适的术前治疗。积极的手术治疗不仅能增加肿瘤的根治性切除,还可以避免肿瘤继续进展带来的并发症。联合门静脉-肠系膜上静脉、腹腔干的切除重建手术安全可行,疗效确切。联合肠系膜上动脉切除值得进一步探索和积累经验。

The prognosis of pancreatic neuroendocrine neoplasms is significantly better than that of pancreatic cancer.Locally advanced pancreatic neuroendocrine tumors can invade the superior mesenteric vein,portal vein,superior mesenteric artery,celiac artery and other large peripancreatic vessels.Preoperative comprehensive examination should be carried out to evaluate and judge the resectability and biological characteristics of the tumor and select appropriate preoperative treatment.Surgical treatment can not only achieve the radical resection of the tumor,but also avoid the complications caused by the continued progress of the tumor.Combined portal vein-superior mesenteric vein and celiac artery resection and reconstruction is safe and effective.Combined superior mesenteric artery resection is worth further exploration and accumulation of experience.