Clinical Study on Inferior Infracolic “Superior Mesenteric Artery First” Approach with Superior Mesenteric-portal Vein Resection in Patients with Pancreatic Head Cancer
YANG Shi-wei,SHI Jun,XIANG Can-hong
Department of Hepato-Biliary-Pancreatic Surgery, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing (102218), China
Abstract:
Objective To investigate the application value of inferior infracolic “Superior Mesenteric Artery First” approach with superior mesenteric-portal vein resection in patients with the pancreatic head cancer. Methods The retrospective descriptive study was conducted. The clinicopathological data of patients with pancreatic head cancer admitted to Beijing Tsinghua Changgung Hospital from June 2015 to March 2018 were collected. The patients were divided into three groups, namely, routine operation with superior mesenteric-portal vein resection (SMPVR group, n=15), the inferior infracolic “Superior Mesenteric Artery First” approach with (AFA+SMPVR group, n=16) or without (AFA group, n=19) superior mesenteric-portal vein resection. The operational factors, postoperative factors, and the follow-up were compared. The follow-up was carried out by telephone and outpatient to understand the survival rate of patients. Results All patients successfully underwent the radical pancreaticoduodenectomy without perioperative death. The operative time of the SMPVR group was less than that of AFA+SMPVR group and AFA group while the blood loss of the AFA group was less than those in the other two groups, (P ＜ 0.05). No severe diarrhea occurred in the SMPVR group. The comparison of the rest complications and clinicopathological data was negative. The median survival time was 19 months, 24 months and 23 months in the SMPVR group, AFA group and AFA+SMPVR group, respectively. Conclusion The inferior infracolic “Superior Mesenteric Artery First” approach with superior mesenteric-portal vein resection in patients with pancreatic head cancer is safe and feasible, which could be used as a fifirst option.
