title: [Observation on the efficacy of modified Appleby operation for carcinoma of the body and tail of the pancreas].
abstract: OBJECTIVE
  To evaluate the security, feasibility and therapeutic efficacy of modified Appleby operation for carcinoma of the body and tail of pancreas.
  
  
  METHODS
  From March 2010 to February 2015 modified Appleby operation was performed in 17 patients with carcinoma of the body and tail of the pancreas. The biochemical indices of fasting plasma blood (FPB), body weight (BW), visual analogue pain intensity scale (VAS score) and the quality of life index were evaluated before and 1 day , 1, 2, 6weeks after surgery. Survival time, tumor recurrence time, hospitalization time and treatment-related complications were analyzed.
  
  
  RESULTS
  There was no hospital mortality in this study. Pancreatic fistula and diarrhea were the major complications. The overall complication rate was 47.1%. The liver function index of ALT and AST were increased on postoperative day 1, and they were restored to normal after one week. Blood glucose has no obvious abnormal increase and abdominal pain was completely relieved. The VAS score decreased after surgery comparing with before (1.9±3.6 vs 83.2±8.5, P<0.05). Life quality assessment was significantly higher. The body weight of patients after surgery has a mean increment of (4.1±1.3)kg than that before surgery (68.1±4.3 vs 64.0±6.7, P<0.05). A significant rise of the overall quality of life index was observed after surgery (93.8±9.7 vs 68.6±6.7, P<0.05). The recurrence rates of 1, 2, 3 and 5 years were 22.9%, 58.9%, 72.6% and 72.6%, respectively. Median recurrence time was (20.0±3.8 m) (95%CI: 12.6-27.4 m). The survival rates of 1, 2, 3 and 5 years were 80.4%, 54.2%, 32.5% and 16.3%, respectively. The median survival time was (26.0±6.0)m (95%CI: 14.2-37.8 m).
  
  
  CONCLUSIONS
  Modified Appleby operation for pancreatic cancer is safe and feasible. It can relieve abdominal pain, improve the quality of life, improve the survival rate and prolong the survival time.
authors.affiliation: Department of General Surgery, Henan Provincial People's Hospital, Zhengzhou 450003, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Shen
authors.forename: Q F
authors.initials: QF
authors.lastname: Jiang
authors.forename: Y W
authors.initials: YW
authors.lastname: Tian
authors.forename: M
authors.initials: M
authors.lastname: Yu
authors.forename: J K
authors.initials: JK
authors.lastname: Jia
authors.forename: H Z
authors.initials: HZ
authors.lastname: Xue
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D002277:Carcinoma / Q000523:psychology / Q000601:surgery*; D005240:Feasibility Studies; D006499:Hepatic Artery / Q000473:pathology / Q000601:surgery; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D011788:Quality of Life; D013157:Splenic Artery / Q000473:pathology / Q000601:surgery; D015996:Survival Rate