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Войти в исследования Surgical laparoscopy, endoscopy & percutaneous techniques · 2026
Optimal Surgical Approach for Peri-Portal Vein Pancreatic Body Cancer: From the Pancreatic Tail or Head Side?
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Yoshiya Shohei, Yamashita Yo-Ichi, Inomata Naotaka, Nakamura Sota, Tada Kazuhiro, Kuroda Yosuke, Iwaki Kentaro, Hiroshige Shoji, Fukuzawa Kengo, Yoshizumi Tomoharu
Аннотация
OBJECTIVE: For peri-portal vein (PV) pancreatic body (Pb) cancer, we have often encountered difficulties in selecting the appropriate surgical approach-whether from the pancreatic tail side or the head side. This study aimed to clarify which procedure is more suitable for peri-PV Pb cancer.
METHODS: We reviewed 30 cases of peri-PV Pb cancer. The resected status of lymph nodes, their positivity rates in each procedure, and postoperative recurrence patterns were analyzed.
RESULTS: Among the 30 patients, 26 underwent distal pancreatectomy (DP), 3 underwent pancreatoduodenectomy, and 1 underwent total pancreatectomy. In the DP group, the gastroduodenal artery (GDA) was dissected to secure resection margins in 4 cases. The pancreatic transection lines were as follows: 1 to the right of the GDA, 3 at the GDA, 8 to the left of the GDA, and 14 to the right of the PV. Pathologic findings revealed the highest rate of lymph node metastasis in the splenic lymph nodes (#11, 32.1%), followed by the common hepatic lymph nodes (#8, 30.0%) and subpancreatic lymph nodes (#18, 18.5%). Only 1 case involved metastasis outside the regional Pb nodes-posterior pancreatic head (#13)-in a patient with suspected preoperative GDA invasion. Postoperative recurrence analysis showed no critical lymph node recurrence in nodes not resected during the initial procedure.
CONCLUSIONS: This study suggests that DP may be an optimal option for peri-PV pancreatic body cancer without invasion of the pancreatic head region.
METHODS: We reviewed 30 cases of peri-PV Pb cancer. The resected status of lymph nodes, their positivity rates in each procedure, and postoperative recurrence patterns were analyzed.
RESULTS: Among the 30 patients, 26 underwent distal pancreatectomy (DP), 3 underwent pancreatoduodenectomy, and 1 underwent total pancreatectomy. In the DP group, the gastroduodenal artery (GDA) was dissected to secure resection margins in 4 cases. The pancreatic transection lines were as follows: 1 to the right of the GDA, 3 at the GDA, 8 to the left of the GDA, and 14 to the right of the PV. Pathologic findings revealed the highest rate of lymph node metastasis in the splenic lymph nodes (#11, 32.1%), followed by the common hepatic lymph nodes (#8, 30.0%) and subpancreatic lymph nodes (#18, 18.5%). Only 1 case involved metastasis outside the regional Pb nodes-posterior pancreatic head (#13)-in a patient with suspected preoperative GDA invasion. Postoperative recurrence analysis showed no critical lymph node recurrence in nodes not resected during the initial procedure.
CONCLUSIONS: This study suggests that DP may be an optimal option for peri-PV pancreatic body cancer without invasion of the pancreatic head region.