PERFORMANCE OF EXTENDED PANCREATIC RESECTION IN TREATMENT OF PATIENTS, SUFFERING ITS TUMOUS

Keywords: pancreatic tumors, surgical treatment, extended pancreatic resection

Abstract

Objective. To estimate the results of performance of extended pancreatic resection in treatment of patients, suffering pancreatic tumors.

Маterials and methods. In 2010 – 2016 yrs 545 patients were operated for pancreatic adenocarcinoma, distal pancreatic resection was performed in 127 (23.3%) of them, pancreaticoduodenal resection (PDR) – in 402 (73.8%), total pancreatectomy – in 16 (2.9%). Extended pancreatic resection was performed in 121 (22.2%) patients, including PDR – in 65 (53.7%), pancreatic distal resection – in 46 (38%), pancreatectomy – in 10 (8.3%). 

Results. Complications have had occurred in 167 (39.4%) patients after standard pancreatic resection and in 51 (42.1%) – after the extended one (c2 = 0.29, p = 0.58). Lethality was 2.6% (14 patients died), of them 5 (4.1%) – after extended pancreatic resection, 9 (2.1%) – a standard one (c2 = 1.52, p = 0.22). Survival median and the general five–year survival indices are nontrustworthy lesser in patients after extended pancreatic resection than after a standard one – 21 mo and 26% and 28 mo and 29% (c2 = 0.15, p = 0.69), accordingly. 

Conclusion. Lethality, morbidity rate, remote results after extended pancreatic resection are comparable with those after its standard resection.

Author Biographies

V. М. Kopchak, Shalimov National Institute of Surgery and Transplantology, Kyiv

PhD, Prof. Head of the Department of Pancreatic Surgery and Bile Ducts Reconstructive Surgery,
Heroiiv Sevastopolya 30st., Kyiv, 03680.
044 454 20 09.

К. V. Коpchak, National Cancer Institute, Kyiv

Kopchak Kostiantyn, PhD. Lead researcher of the research department of abdominal tumors.
Lomonosov 33/43 st., Kyiv, 03022.
044 257 93 15.

L. О. Pererva, Shalimov National Institute of Surgery and Transplantology, Kyiv

PhD. Scientific researcher of the Departmentof Pancreas Surgery and Bile Ducts Reconstructive Surgery.
Heroiiv Sevastopolya 30 st., Kyiv, 03680.
044 454 20 09

І. V. Khomyak, Shalimov National Institute of Surgery and Transplantology, Kyiv

PhD, Prof. Chief researcher of the Department of Pancreas Surgery and Bile Ducts Reconstructive Surgery.
Heroiiv Sevastopolya 30 st., Kyiv, 03680.
044 454 20 09.

О. V. Duvalko, Shalimov National Institute of Surgery and Transplantology, Kyiv

hD. Senior Researcher of the Department of Pancreas Surgery and Bile Ducts Reconstructive Surgery.
Heroiiv Sevastopolya 30 st., Kyiv, 03680.
044 454 20 09.

G. G. Shevkolenko, Shalimov National Institute of Surgery and Transplantology, Kyiv

Surgeon of the Department of Pancreas Surgery, Laparoscopic and Reconstructive Surgery of Bile Ducts.
Heroiiv Sevastopolya 30 st., Kyiv, 03680.
044 40818 00

N. G. Davydenko, Shalimov National Institute of Surgery and Transplantology, Kyiv

Doctor-anesthesiologist, head of department of anesthesiology and intensive therap.
Heroiiv Sevastopolya 30 st., Kyiv,
03680.044 40818 00.

S. V. Аndronik, Shalimov National Institute of Surgery and Transplantology, Kyiv

Andronik Serhii, Surgeon of the Department of Pancreas Surgery, Laparoscopic and Reconstructive Surgery of Bile Ducts.
Heroiiv Sevastopolya 30st., Kyiv, 03680
044 454 20 09.

І. V. Skrypnychuk, Shalimov National Institute of Surgery and Transplantology, Kyiv

Intern of the Department of Pancreas Surgery, Laparoscopic and Reconstructive Surgery of Bile Ducts.
Heroiiv Sevastopolya 30 st., Kyiv, 03680.
044 454 20 09.

References

1. Kaiser J, Hackert T, Buchler MW. Extended pancreatectomy: Does it have a role in the contemporary management of pancreatic adenocarcinoma? Dig Surg. 2017 July 13. DOI: 10.1159/000478539.

2. Hartwig W, Gluth A, Hinz U, Koliogiannis D, Strobel O, Hackert T, et al. Outcomes after extended pancreatectomy in patients with borderline resectable and locally advanced pancreatic cancer. Br J Surg. 2016 Nov;103(12):1683–94. DOI: 10.1002/bjs.10221.

3. Sinn M, Bahra M, Denecke T, Travis S, Pelzer U, Riess H. Perioperative treatment options in resectable pancreatic cancer – how to improve long–term survival. World J Gastrointest Oncol. 2016;8(3):248–57. DOI: 10.4251/wjgo.v8.i3.248.

4. Kasumova GG, Conway WC, Tseng JF. The role of venous and arterial resection in pancreatic cancer surgery. Ann Surg Oncol. 2016 Nov;23:1–8. DOI: 10.1245/s10434–016–5676–3.

5. Hartwig W, Vollmer CM, Fingerhut A, Yeo CJ, Neoptolemos JP, Adham M, et al. Extended pancreatectomy in pancreatic ductal adenocarcinoma: definition and consensus of the International Study Group for Pancreatic Surgery (ISGPS). Surgery. 2014;156:1–14. DOI: 10.1016/i.surg.2014.02.009.

6. He J, Page AJ, Weiss M, Wolfgang CL, Herman JM, Pawlik TM. Management of borderline and locally advanced pancreatic cancer: where do we stand? World J Gastroenterol. 2014;20:2255–66. DOI: 10.3748/wjg.v20.i9.2255.

7. Selvaggi F, Mascetta G, Daskalaki D, Molin M, Salvia R., Butturini G.
Outcome of superior mesenteric–portal vein resection during pancreatectomy for borderline ductal adenocarcinoma: results of a prospective comparative study. Langenbeck’s Arch Surg. 2014;399:659–65. DOI:10.1007/s00423–014–1194–6.

8. Ohgi K, Yamamoto Y, Sugiura T, Okamura Y, Ito T, Ashida R. Is pancreatic head cancer with portal venous involvement really borderline resectable? Appraisal of an upfront surgery series. Ann Surg Oncol. 2017 Sep;24(9):2752–61. DOI:10.1245/s10434–017–5972–6.

9. Takaori K, Bassi C, Biankin A, Brunner T, Cataldo I, Campbell I, et al. International Association of Pancreatology (IAP)/European Pancreatic Club (EPC) consensus review of guidelines for the treatment of pancreatic cancer. Pancreatology. 2016;16:14–27. DOI:10.1016/j.pan.2015.10.013.

10. Ducreux M, Cuhna A, Caramella C, Hollebecque A, Burtin P, Goere D, et al. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow–up. Ann Oncol. 2015;26, suppl 5: 56–68. DOI:10.1093/annonc/mdv295.
Published
2017-07-29
Section
General Problems of Surgery