Objective:To investigate the clinical efficacy of pancreatic cancer surgery with arterial resection.Methods:The clinicopathological and follow-up data of 135 patients undergoing pancreatectomies with arterial resection in Pancreas Center, the First Affiliated Hospital of Nanjing Medical University from Sep 2013 to Dec 2023 were retrospectively analyzed.Results:There were 77 males and 58 females, with age [ M( IQR)] of 63 (14) years old. Among the 135 patients, 122 (90.4%) were distal pancreatectomies, 8 (5.9%) were pancreaticoduodenectomies, 4 (3.0%) were total pancreatectomies and 1 (0.7%) was resection for local recurrence after distal pancreatectomy. There were 120 (88.9%) celiac axis resections, 11 (8.1%) hepatic artery resections, 1 (0.7%) superior mesenteric artery resection and 3 (2.2%) other artery resections. Simultaneous portal vein-superior mesenteric vein or organ resection accounted for 26.7% (36/135) and 29.6% (40/135),respectively. The median blood loss was 300 (300) ml and the median operation time was 275 (105) minutes. The 90-day mortality rate was 7.4% (10/135). The overall morbidity rate was 70.4% (95/135) while the major morbidity rate was 18.5% (25/135). Postoperative hemorrhage occurred in 8.9% (12/135), clinically relevant postoperative pancreatic fistula in 57.0% (77/135), bile leak in 0.74% (1/135), delayed gastric emptying in 9.6% (13/135), liver failure in 3.7% (5/135) and transient liver enzyme elevation in 44.4% (60/135). All of the 135 cases were confirmed as pancreatic cancer histologically, including 54.6% (71/130) moderately differentiated, 45.4% (59/130) poorly differentiated and no for well differentiated. The median tumor size was 4.5 (2.3) cm. The median number of harvested lymph nodes was 14 (13) and the percentage of N0, N1 and N2 according to AJCC 8th staging system was 27.1% (36/133), 52.6% (70/133) and 20.3% (27/133), respectively. The R 0 resection was achieved in 40 of 123 cases (32.5%), whose margins of specimens were assessed circumferentially based on the 1mm rule. The median overall survival time (MST) after surgery was 22.5 months, and the median progress-free survival time was 16.1 months. The overall survival rate at 1-, 2- and 5-year was 71.5%, 45.1% and 11.3%, respectively. The MST of patients who received no adjuvant therapy, chemotherapy after surgery was 8.4 months, 25.3 months, respectively. Conclusions:Pancreatectomy with arterial resection is generally safe and feasible. Survival outcome improves significantly when combined with adjuvant chemotherapy.

Objective:To investigate the clinical efficacy of pancreatic cancer surgery with arterial resection.Methods:The clinicopathological and follow-up data of 135 patients undergoing pancreatectomies with arterial resection in Pancreas Center, the First Affiliated Hospital of Nanjing Medical University from Sep 2013 to Dec 2023 were retrospectively analyzed.Results:There were 77 males and 58 females, with age [ M( IQR)] of 63 (14) years old. Among the 135 patients, 122 (90.4%) were distal pancreatectomies, 8 (5.9%) were pancreaticoduodenectomies, 4 (3.0%) were total pancreatectomies and 1 (0.7%) was resection for local recurrence after distal pancreatectomy. There were 120 (88.9%) celiac axis resections, 11 (8.1%) hepatic artery resections, 1 (0.7%) superior mesenteric artery resection and 3 (2.2%) other artery resections. Simultaneous portal vein-superior mesenteric vein or organ resection accounted for 26.7% (36/135) and 29.6% (40/135),respectively. The median blood loss was 300 (300) ml and the median operation time was 275 (105) minutes. The 90-day mortality rate was 7.4% (10/135). The overall morbidity rate was 70.4% (95/135) while the major morbidity rate was 18.5% (25/135). Postoperative hemorrhage occurred in 8.9% (12/135), clinically relevant postoperative pancreatic fistula in 57.0% (77/135), bile leak in 0.74% (1/135), delayed gastric emptying in 9.6% (13/135), liver failure in 3.7% (5/135) and transient liver enzyme elevation in 44.4% (60/135). All of the 135 cases were confirmed as pancreatic cancer histologically, including 54.6% (71/130) moderately differentiated, 45.4% (59/130) poorly differentiated and no for well differentiated. The median tumor size was 4.5 (2.3) cm. The median number of harvested lymph nodes was 14 (13) and the percentage of N0, N1 and N2 according to AJCC 8th staging system was 27.1% (36/133), 52.6% (70/133) and 20.3% (27/133), respectively. The R 0 resection was achieved in 40 of 123 cases (32.5%), whose margins of specimens were assessed circumferentially based on the 1mm rule. The median overall survival time (MST) after surgery was 22.5 months, and the median progress-free survival time was 16.1 months. The overall survival rate at 1-, 2- and 5-year was 71.5%, 45.1% and 11.3%, respectively. The MST of patients who received no adjuvant therapy, chemotherapy after surgery was 8.4 months, 25.3 months, respectively. Conclusions:Pancreatectomy with arterial resection is generally safe and feasible. Survival outcome improves significantly when combined with adjuvant chemotherapy.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.

The development of multi-campus districts has become an important initiative for the country to expand high-quality medical resources and build a high-quality and efficient medical and healthcare service system,and is an important implementation path for the high-quality development of public hospitals.The symbiosis theory is highly applicable to multi-campus hospital development,and can provide a new perspective for the exploration of multi-campus hospital collaborative development.Through the construction of the symbiotic framework based on symbiotic unit,symbiotic interface,symbiotic environment and symbiotic model,it analyzed the symbiotic dilemma of multi-campus hospital collaborative development,and proposed the path of multi-campus hospital collaborative development,in order to provide reference for the subsequent construction and development of multi-campus hospital in China.