title: [Results of the modified Appleby procedure].
abstract: OBJECTIVE
  To evaluate safety and efficacy of distal pancreatectomy with en bloc celiac artery resection (DP-CAR) for pancreatic malignancy.
  
  
  METHODS
  Medical reports of 17 patients who underwent DP-CAR procedure (15 of them with pancreatic malignancy) were retrospectively analyzed. Also we studied 27 publications describing more than 2 cases of DP-CAR.
  
  
  RESULTS
  R0- and R1-resection was performed in 14 (82%) and 3 (18%) patients respectively. Postoperative complications ware observed in 11 (65%) cases. Nine of them were successfully treated. Full pain control was achieved in all patients. There were no any ischemic complications. 16 patients received chemotherapy. 2 (11%) patients died in early postoperative period due to aortic dissection in 10 days and fungal sepsis in 44 days after surgery. Median survival was 20 months. Literature review included 27 articles describing 311 operations. Herewith postoperative complications developed in 43% of cases and 90-day postoperative mortality was 4%. Median survival ranged from 9.3 to 26 months.
  
  
  CONCLUSIONS
  DP-CAR is effective and safe procedure in certain patients with locally advanced pancreatic cancer.
authors.affiliation: City Clinical Hospital #5, Moscow Department of Health.
authors.forename: V I
authors.initials: VI
authors.lastname: Egorov
authors.affiliation: City Clinical Hospital #5, Moscow Department of Health.
authors.forename: R V
authors.initials: RV
authors.lastname: Petrov
authors.affiliation: Moscow Clinical Research Center, Moscow.
authors.forename: N S
authors.initials: NS
authors.lastname: Starostina
authors.affiliation: City Clinical Hospital #5, Moscow Department of Health.
authors.forename: Yu A
authors.initials: YA
authors.lastname: Zhurina
authors.affiliation: A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of the Russian Federation, Moscow.
authors.forename: M V
authors.initials: MV
authors.lastname: Grigorievsky
mesh_terms: D000328:Adult; D000368:Aged; D002445:Celiac Artery / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods