[Clinical significance of nerve, lymph node and soft tissue dissection in retroperitoneum in radical resection of ductal adenocarcinoma in pancreatic head].

OBJECTIVE

To investigate the clinical significance of radical pancreatoduodenectomy plus retroperitoneal nerve, lymph node and soft tissue dissection in carcinoma of pancreatic head.

METHODS

Forty-six patients with carcinoma of pancreatic head were treated at our hospital from 1995 to 2005. They were divided into two groups: radical pancreatoduodenectomy plus retroperitoneal nerve, lymph node and soft tissue dissection (Group A, n = 25) and routine Whipple's operation (Group B, n = 21). Two groups had no significant difference in age, gender and pre-operative risk factors. And the peri-operative conditions, pathological data and survival rates were compared and analyzed.

RESULTS

There was no difference in tumor size, intra-operative findings, post-operative complications and length of hospitalization. But the number and positive rate of resected lymph node in Group A were significantly higher than those in Group B (P < 0.05). The survival rates of 1, 3-year in Group A were 80% and 52.9% respectively. And they were higher than those in Group B (P < 0.05). There was significant difference in the survival rates between patients with nerve infiltration and those without in Group A (P < 0.05).

CONCLUSION

The radical pancreatoduodenectomy plus retroperitoneal nerve, lymph node and soft tissue dissection can effectively remove the lymph node and nerve tissues with tumor infiltration and reduce the local recurrent rate so as to improve the long-term survival rate.