title: Distal pancreatectomy with celiac axis resection for pancreatic body and tail cancer invading celiac axis.
abstract: OBJECTIVE
  Pancreatic body/tail cancer often involves the celiac axis (CA) and it is regarded as an unresectable disease. To treat the disease, we employed distal pancreatectomy with en bloc celiac axis resection (DP-CAR) and reviewed our experiences.
  
  
  METHODS
  We performed DP-CAR for seven patients with pancreatic body/tail cancer involving the CA. The indications of DP-CAR initially included tumors with definite invasion of CA and were later expanded to include borderline resectable disease. To determine the efficacy of DP-CAR, the clinico-pathological data of patients who underwent DP-CAR were compared to both distal pancreatectomy (DP) group and no resection (NR) group.
  
  
  RESULTS
  The R0 resection rate was 71.4% and was not statistically different compared to DP group. The operative time (P = 0.018) and length of hospital stay (P = 0.022) were significantly longer in DP-CAR group but no significant difference was found in incidence of the postoperative pancreatic fistula compared to DP group. In DP-CAR group, focal hepatic infarction and transient hepatopathy occurred in 1 patient and 3 patients, respectively. No mortality occurred in DP-CAR group. The median survival time (MST) was not statistically different compared to DP group. However, the MST of DP-CAR group was significantly longer than that of NR group (P < 0.001).
  
  
  CONCLUSIONS
  In our experience, DP-CAR was safe and offered high R0 resection rate for patients with pancreatic body/tail cancer with involvement of CA. The effect on survival of DP-CAR is comparable to DP and better than that of NR. However, the benefits need to be verified by further studies in the future.
authors.affiliation: Departmet of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Hyemin
authors.initials: H
authors.lastname: Ham
authors.affiliation: Department of Surgery, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Sang Geol
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Department of Surgery, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Hyung Jun
authors.initials: HJ
authors.lastname: Kwon
authors.affiliation: Department of Surgery, Kyungpook National University Medical Center, Daegu, Korea.
authors.forename: Heontak
authors.initials: H
authors.lastname: Ha
authors.affiliation: Departmet of Surgery, Kyungpook National University School of Medicine, Daegu, Korea.
authors.forename: Young Yeon
authors.initials: YY
authors.lastname: Choi
keywords: Celiac artery; Pancreatectomy; Pancreatic neoplasm