关键词: 胰腺癌, 胰腺神经内分泌肿瘤, 全胰腺切除术, 血管重建, 临床疗效

Abstract: Objective To investigate the clinical effect of total pancreatectomy in the treatment of advanced pancreatic cancer.
Methods Clinical data of 9 TP patients administered were analyzed retrospectively in the pancreatic center of Ruijin Hospital affiliated to Shanghai Jiaotong University Medical College from June 2019 to June 2020.The clinical effect was discussed by analyzing the data of preoperative general data,operation time,intraoperative bleeding volume,intraoperative portal vein occlusion time and postoperative complications.
Results Total pancreatectomy plus jejunostomy was successfully performed in 9 patients,of which 4 patients underwent vascular resection and reconstruction due to pancreatic tumor involvement of portal vein/superior mesenteric vein.The operation time of 9 patients was 300~540 min,with an average of (385±55)min.The intraoperative blood loss ranged from 200 to 1 800 ml,with an average of (475±205)ml.The intraoperative time of portal vein occlusion was 19~45min,with an average of (26±7)min.The postoperative hospital stay was 12~35 days,with an average of (17±5)days.The most common complication after TP was postoperative fragile diabetes (7 cases),followed by postoperative gastric emptying disorder (2 cases),abdominal hemorrhage (1 case),biliary fistula (1 case),and colon fistula (1 case).After 6 months of follow-up,1 patient died,1 patient had liver metastasis,1 patient had multiple systemic metastasis,the remaining 5 patients had good survival.〖WT5”HZ〗Conclusion TP can reduce digestive tract reconstruction and complications in patients with multiple pancreatic cancer and pancreatic neuroendocrine tumors (multiple sites) and other middle and advanced pancreatic cancer.With definite surgical effect,TP can be used in patients with clinical indications.

Key words: pancreatic cancer, pancreatic neuroendocrine tumor, total pancreatectomy, vascular remodeling, clinical curative effect