["Three steps procedure" in the treatment of large pancreatic head cancer].
OBJECTIVE
To evaluate the feasibility and effectivity of "3 steps procedure" in the treatment of large pancreatic head cancer.


METHODS
The "3 steps procedure" consisted of decompression of jaundice by simple cholecystotomy, intervenient (intra-arterial) chemotherapy (5-FU 1 approximately 1.5 g, mitomycin 8 approximately 14 mg, cisplatin 40 approximately 60 mg and octreatide 1 mu intravenously as near the superior and inferior pancreatic-duodenal arteries as possible), and then the reasonable regional pancreatic-duodenectomy.


RESULTS
All 16 tumors were radically resected. Conventional and regional pancreatic-duodenectomy was done in 7 and 9 patients, respectively; of the later group, artificial prosthesis for portal vein bridge was done in 3 patients, end-to-end anastomosis in 4 and repair after partial resection of invaded vessel wall in 2.


CONCLUSIONS
The "3 steps procedure" is feasible and effective in the treatment of large pancreatic head cancer.
Ni
Q
Q
Center for Pancreatic Cancer, Huashan Hospital, Shanghai Medical University, Shanghai 200040, China.
Zhang
Q
Q
Cao
G
G
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D002767:Cholecystostomy; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004386:Duodenum / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D005704:Gallbladder / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin; D015282:Octreotide / Q000627:therapeutic use; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D016685:Mitomycin; D002945:Cisplatin; D015282:Octreotide; D005472:Fluorouracil