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Laparoscopic Radical Antegrade Modular Pancreatosplenectomy with Portal Vein Reconstruction and Celiac Axis Resection for Pancreatic Neck-Body Cancer

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机构: [1]Army Med Univ, Southwest Hosp, Inst Hepatobiliary Surg Army, Chongqing, Peoples R China [2]Qujing Cent Hosp, Qujing Peoples Hosp 1, Gastroenterol Dept, Yunnan Reg Med Ctr, Qujing, Peoples R China [3]Chongqing Univ, Chongqing Gen Hosp, Chongqing Key Lab Intelligent Med Engn Hepatopancr, Chongqing, Peoples R China
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关键词: Laparoscopic radical antegrade modular pancreatosplenectomy Modified appleby procedure Portal vein reconstruction Neoadjuvant therapy Pancreatic neck-body cancer

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BackgroundLaparoscopic radical antegrade modular pancreatosplenectomy combined with celiac axis resection and portal vein reconstruction is a new procedure for the treatment of pancreatic cancer. This surgical technique may offer patients with pancreatic cancer involving the portal vein and celiac axis an opportunity for radical surgical resection. We aim to evaluate the short- and long-term efficacy and describe the surgical details of this technique.Patients and MethodsA 74-year-old man was diagnosed with pancreatic neck-body cancer, with a tumor size of 2.5 x 2.0 x 1.5 cm and local vascular invasion of the celiac axis, common hepatic artery, and portal vein. After four cycles of modified neoadjuvant folinic acid, fluorouracil, oxaliplatin, and irinotecan (FOLFIRINOX) therapy, reevaluation showed that the tumor size had considerably reduced, and the surrounding enlarged lymph nodes disappeared. Laparoscopic radical antegrade modular pancreatosplenectomy, combined with celiac axis resection and portal vein reconstruction, was performed.ResultsThe operative time was 300 min, with blood loss of 200 mL. The drainage tube was removed 5 days postoperatively, and the patient was discharged 9 days later. The patient received eight cycles of modified FOLFIRINOX chemotherapy over the following month. After 15 months of follow-up, no tumor recurrence or metastasis was observed.ConclusionsLaparoscopic radical antegrade modular pancreatosplenectomy, combined with celiac axis resection and portal vein reconstruction, is a safe and effective treatment option for patients with pancreatic neck-body cancer involving the celiac axis and portal vein.

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大类 | 2 区 医学
小类 | 2 区 外科 3 区 肿瘤学
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出版当年[2023]版:
Q1 SURGERY Q2 ONCOLOGY
最新[2023]版:
Q1 SURGERY Q2 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2023版] 出版当年五年平均 出版前一年[2022版]

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第一作者机构: [1]Army Med Univ, Southwest Hosp, Inst Hepatobiliary Surg Army, Chongqing, Peoples R China
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