Distal pancreatectomy combined with celiac axis resection in treatment of carcinoma of the body/tail of the pancreas: a single-center experience.
BACKGROUND
Few comparison studies have been carried out on patients with distal pancreatectomy (DP) combined with celiac axis (CA) resection. The aim of this study was to assess the safety and efficacy of this extended procedure in treatment of advanced carcinoma of the body/tail of the pancreas.


METHODS
This was a retrospective analysis of 206 patients with carcinoma of the body/tail of the pancreas from January 2003 through June 2008. Patients were divided into three groups based on the relationship of tumor and CA/common hepatic artery (CHA) as well as different treatment strategies. Data for operation time, blood loss, complications, and survival time were collected and statistically analyzed.


RESULTS
Sixty-five patients (31.6%) received radical distal pancreatectomy (DP), including 11 patients who underwent DP combined with celiac axis resection (group A) and 54 patients who received conventional DP (group B). Twenty patients did not undergo DP because of CA and/or CHA invasion only (group C). Group A had longer mean operative time than group B (323 versus 225 min, P = 0.000); there was no difference in mean estimated blood loss, percentage of pancreatic fistula or median survival time (14 versus 15 months, P = 0.197). However, group A had significantly prolonged median survival time compared with the 20 patients in group C (14 versus 5 months, P = 0.013), and quality of life was also dramatically improved.


CONCLUSIONS
DP combined with CA resection can be safely performed in certain patients with carcinoma of body/tail of the pancreas and significantly improves patient survival and quality of life.
Wu
Xubo
X
Department of General Surgery, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Tao
Ran
R
Lei
Ruoqing
R
Han
Baosan
B
Cheng
Dongfeng
D
Shen
Baiyong
B
Peng
Chenghong
C
D000230:Adenocarcinoma; D018262:Adenocarcinoma, Clear Cell; D002288:Adenocarcinoma, Mucinous; D000328:Adult; D000368:Aged; D018267:Carcinoma, Acinar Cell; D002445:Celiac Artery / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome