Application value of "total arterial devascularization ifrst" in radical resection of typeⅡpancreatic head carcinoma
10.3877/cma.j.issn.2095-3232.2014.06.003
- VernacularTitle:全动脉优先离断法在Ⅱ型胰头癌根治性切除中的应用价值
- Author:
Min WANG
1
;
Feng ZHU
;
Rui TIAN
;
Chengjian SHI
;
Feng PENG
;
Meng XU
;
Renyi QIN
Author Information
1. 华中科技大学同济医学院附属同济医院胆胰外科
- Keywords:
Pancreatic neoplasms;
Classification of the pancreatic head carcinoma;
Pancreatoduodenectomy;
Total arterial devascularization ifrst;
Postoperative complication
- From:
Chinese Journal of Hepatic Surgery（Electronic Edition）
2014;(6):13-16
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate the application value of "total arterial devascularization first" (TADF) in radical resection of typeⅡ pancreatic head carcinoma.MethodsClinical data of 86 patients with typeⅡ pancreatic head carcinoma undergoing radical pancreatoduodenectomy by TADF in Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from May 2012 to January 2014 were analyzed retrospectively. There were 51 males and 35 females with the age ranging from 42 to 78 years and median age of 65 years. The informed consents of all patients were obtained and the ethical committee approval was received. The pancreatic vessels in all the patients were treated by TADF. Occluding bands of the superior mesenteric vein (SMV)/portal vein (PV) and superior mesenteric artery (SMA) were preset. Pancreatic neck was cut off. Along the anterior, right, posterior surfaces of SMA, vessels and neural connective tissues between pancreatic head and SMA, celiac aorta were totally dissected and cut off. The involved SMV/PV were stripped or resected, and reconstructed. Then the en-bloc tumor was removed. The perioperative situation was observed including operative completion, surgical procedures, intraoperative blood loss and postoperative complications.ResultsRadical pancreatoduodenectomy was performed successfully in all 86 cases. The operation duration was 4.6-8.3 h, intraoperative blood loss was 200-600 ml. The operation included SMV sidewall resection and repair (n=26), SMV resection and end to end anastomosis (n=12). No death case was observed during the perioperative period. The incidences of postoperative hemorrhage, pancreatic ifstula were 6% (5/86), 8% (7/86) respectively.ConclusionsApplying TADF in radical resection of typeⅡ pancreatic head carcinoma can ensure the safety of operation, reduce the intraoperative blood loss, improve the general and radical resection rates, and decrease the SMV/PV accidental cutting rate.
