关键词: 胰体尾切除术, 联合脏器切除, 动脉优先入路, 根治性顺行模块化胰脾切除术, 胰腺癌

Abstract: Objective   To investigate the value of arterial priority approach combined with radical anterograde modular pancreaticosplenectomy in the resection of pancreatic body and tail cancer combined with multiple organs． Methods   The clinical data of 12 patients with pancreatic body and tail cancer combined with multiple organ resection in Taizhou People’s Hospital Affiliated to Nanjing Medical University from December 2014 to January 2022 were analyzed retrospectively.Preoperative evaluation was based on CT or MRI plain scan plus enhancement.During the operation,arterial priority approach combined with radical anterograde modular pancreaticosplenectomy was used,and combined with multiple organ resection.Postoperative complications were treated in time. Results   All patients were successfully completed surgery,no perioperative death.The operation time was (375±43) min and the amount of intraoperative bleeding was (280±40) ml.Postoperative pathology showed that the cutting edges of all specimens were negative,nerves were involved,lymph nodes were cleaned (23±6),and lymph node metastasis occurred in 10 of 12 cases.The incidence of postoperative complications was 50%,including 3 cases of grade A pancreatic fistula,no grade B and C pancreatic fistula,1 case of gastric emptying disorder,1 case of lymphatic fistula and 1 case of adhesive intestinal obstruction,which were cured by conservative treatment.No colonic anastomotic leakage and renal cortical crisis occurred.All patients were cured and discharged,with an average hospitalization of 18.6 days. Conclusions   Using the method of arterial priority approach combined with radical anterograde modular pancreaticosplenectomy,pancreatic body and tail cancer combined with multi organ resection ensures the radical resection of the tumor,less intraoperative bleeding,safe and feasible.

Key words: resection of body and tail of pancreas, combined organ resection, arterial priority approach, radical anterograde modular pancreaticosplenectomy, pancreatic cancer