Laparoscopic subtotal distal pancreatectomy using the arterial first approach in patients who underwent post-neoadjuvant chemotherapy for pancreatic neck-body cancer
10.3760/cma.j.cn113884-20220412-00159
- VernacularTitle:腹腔镜下动脉优先入路次全远端胰腺切除术治疗新辅助化疗后胰颈体癌
- Author:
Jia LI
1
;
Guoguang LI
;
Maitao HU
;
Shaofeng CHEN
;
Yangyun XIE
;
Chuang PENG
;
Wei CHENG
Author Information
1. 湖南省人民医院（湖南师范大学附属第一医院）胰脾外科，长沙 410005
- Keywords:
Laparoscopy;
Pancreatic neck-body cancer;
Neoadjuvant chemotherapy;
Artery first;
Subtotal distal pancreatectomy
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(10):755-760
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the safety and efficacy of laparoscopic subtotal distal pancreatectomy using the arterial first approach in treatment of patients with pancreatic neck-body cancer after neoadjuvant chemotherapy.Methods:The clinical data of patients who underwent laparoscopic subtotal distal pancreatectomy after neoadjuvant chemotherapy at the Department of Pancreatic Surgery, Hunan Provincial People's Hospital from January 2019 to June 2021 were analyzed retrospectively. Seven patients were included in this study. There were 3 males and 4 females, aged 55(46, 67) years old. The clinical data analysed included chemotherapy, preoperative, intraoperative, postoperative and follow-up data. Follow up was done by outpatient visits, or contact using wechat or telephone.Results:Five borderline staged patients were treated with the AG chemotherapy regimen (gemcitabine+ albumin-bound paclitaxel), and two patients with locally advanced stage were treated with the mFOLFIRINOX chemotherapy regimen (oxaliplatin+ irinotecan+ calcium folate+ fluorouracil). All the 7 patients underwent portal vein/superior mesenteric vein resection and reconstruction using the superior mesenteric artery priority approach. The operation time was 400(350, 440) min, and the intraoperative blood loss was 300(150, 400) ml. Postoperative complications occurred in 2 patients with grade B pancreatic fistula and refractory ascites in 1 patient each. The postoperative hospital stay was 11(10, 14) days. All 7 patients underwent R 0 resection. During a follow-up period of 9 to 33 months, 5 patients were still alive without tumor, 1 patient survived with tumor, and 1 patient had died of recurrence. Conclusion:In selected cases, laparoscopic subtotal distal pancreatectomy for pancreatic neck-body cancer after neoadjuvant chemotherapy was safe and feasible.
