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胰腺癌具有嗜神经侵袭和转移特性,神经组织内癌细胞残留是胰腺癌术后复发的重要原因。然而,传统胰腺癌根治术并未重视胰腺周围神经丛的清扫。目前,对于胰头癌病人行联合胰周神经清扫的手术指征和清扫范围仍缺乏统一标准。建议对相对早期胰头癌进行联合神经清扫的胰十二指肠切除术,重点对胰头后方神经丛、肠系膜上动脉环绕270?及腹腔干右侧180?以上进行完整清扫,并推荐采用肠系膜上动脉先行游离的手术路径。
Pancreatic cancer has the characteristics of parasympathetic nerve and metastasis. The residual cancer cells in nerve tissue is an important reason for the recurrence of pancreatic cancer. However, the traditional pancreatic cancer radical surgery did not pay attention to the pancreas around the plexus. At present, there is still a lack of uniform standards for surgical indications and the extent of dissection of pancreas in patients with pancreatic head cancer. Proposed pancreaticoduodenectomy for early pancreaticoduodenectomy, focusing on the posterior plexus of the pancreas, the superior mesenteric artery around 270? And the right side of the celiac trunk more than 180? Complete cleaning, and recommended the use of mesentery Artery on the first free surgical path.