Surgical Treatment of Pancreatic Cancer —— Special Topic Issue: Digestive Surgery 1999, Vol. 16, No. 4

----- 胰腺癌的外科治疗

ISBN: 9783805569378 出版年：1999 页码：87 S.Karger

Pancreatic cancer is one of the most hazardous as most patients have advanced (and therefore incurable) disease at the time of diagnosis. In terms of treatment, surgery is still the main option: Radical resection offers the only opportunity to cure patients with pancreatic ductal adenocarcinoma. However, exact diagnosis and staging are difficult and not always cost-effective, and even in those patients that are considered resectable, surgical exploration will show irresectable tumors in more than half of them. For those with resectable pancreatic head tumors, pancreatoduodenectomy is indicated, and distal pancreatectomy for resectable body and tail tumors. No uniformity exists on the technique of the operation and extent of lymph node dissection during pancreatectomy, and there is as yet no standardization of the nomenclature. The last part of this publication is there-fore dedicated to the results of a consensus meeting of surgeons and pathologists, where agreement was reached on the nomenclature of three types of Kausch-Whipple operations. Adherence to one of the three techniques described and the use of a defined terminology will make a comparison of results from different surgeons possible. Cost-effective preoperative diagnosis and staging leading to selection of patients that could benefit from resection and the best palliative support in all others is the best we can do. Even then, surgery plays a minor role in the cure, and novel therapies including immunotherapy and gene therapy should be explored.