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目的:评价近端胰腺非侵袭性肿瘤剜除手术的安全性与有效性。创新点:以目前为止最大样本量的近端胰腺非侵袭性肿瘤的剜除手术的数据分析,证实了剜除手术在这类患者中的安全性和有效性,即使肿瘤直径>3 cm或临近主胰管肿瘤。并且首次报道和证实了在这些患者剜除手术中发生主胰管损伤,进行主胰管修补与支架置入是安全有效的。分析了同期进行不同手术方式患者的肿瘤资料,阐明了肿瘤大小影响手术策略的制定。方法:详细对比了剜除手术和传统的胰十二脂肠切除术以及胰腺中段切除术的术前情况、术中情况、术后并发症资料(表1~3),尤其详细描述了临近主胰管和主胰管有损伤的患者剜除手术后并发症情况(表4)。同时,附图说明了主胰管修补手术方法(图1)。结论:近端胰腺非侵袭性肿瘤的剜除手术是安全有效的,应该是这类患者手术治疗的首选推荐方式,在大肿瘤和临近主胰管的肿瘤患者中也可施行。
PURPOSE: To evaluate the safety and efficacy of surgical resection of proximal pancreatic non-invasive tumors. Innovation: Data analysis of resection of the largest sample of proximal non-invasive pancreatic neoplasms to date confirms the safety and efficacy of surgical resection in these patients, even if the tumor diameter is> 3 cm or near Primary pancreatic duct tumor. It was the first time to report and confirm that it is safe and effective to repair the primary pancreatic ducts and perform the repair of the primary pancreatic duct and the placement of the stents during these operations. Tumor data of patients with different surgical modalities during the same period were analyzed, and the development of surgical strategies influencing tumor size was clarified. METHODS: A detailed comparison of preoperative and postoperative complications and data on postoperative complications (Table 1 to 3) was made in detail comparing patients who underwent surgery and traditional pancreaticoduodenectomy and pancreatic resection. In particular, Patients with impaired pancreatic duct and primary pancreatic duct removed postoperative complications (Table 4). Meanwhile, the figure illustrates the main pancreatic duct repair surgery method (Figure 1). CONCLUSIONS: Resection of proximal pancreatic non-invasive tumors is safe and effective and should be the preferred method of surgical treatment for these patients. It may also be performed in large and near-primary pancreatic cancer patients.