Efficacy and safety of laparoscopic radical resection following neoadjuvant therapy for pancreatic ductal adenocarcinoma:A retrospective study  

作　　者：Yong-Gang He Xiao-Bing Huang Yu-Ming Li Jing Li Xue-Hui Peng Wen Huang Yi-Chen Tang Lu Zheng 

机构地区：[1]Department of Hepatobiliary,The Second Affiliated Hospital of Army Medical University,Chongqing 400037,China

出　　处：《World Journal of Gastrointestinal Oncology》2022年第9期1785-1797,共13页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by Chongqing Municipal Science and Technology Talent Project,No. csct2017jcyj-yszx X0002;Chongqing Municipal Science and Technology Innovation Project for Social Undertakings and People’s Livelihood Guarantee,No. cstc2018jscx-mszd X0012;the Natural Science Foundation of Chongqing,No. cstc2021jcyj-msxm X0991。

摘　　要：BACKGROUND Multiple studies have demonstrated that neoadjuvant chemotherapy(NACT) can prolong the overall survival of pancreatic ductal adenocarcinoma(PDAC) patients. However, most studies have focused on open surgery following NACT.AIM To investigate the efficacy and safety of laparoscopic radical resection following NACT for PDAC.METHODS We retrospectively analyzed the clinical data of 15 patients with pathologically confirmed PDAC who received NACT followed by laparoscopic radical surgery in our hospital from December 2019 to April 2022. All patients underwent abdominal contrast-enhanced computed tomography(CT) and positron emission tomography-CT before surgery to accurately assess tumor stage and exclude distant metastasis.RESULTS All 15 patients with pancreatic cancer were successfully converted to surgical resection after NACT, including 8 patients with pancreatic head cancer and 7 patients with pancreatic body and tail cancer. Among them, 13 patients received the nab-paclitaxel plus gemcitabine regimen(gemcitabine 1000 mg/m^(2) plus nabpaclitaxel 125 mg/m^(2) on days 1, 8, and 15 every 4 wk) and 2 patients received the modified FOLFIRINOX regimen(intravenous oxaliplatin 68 mg/m^(2), irinotecan 135 mg/m^(2), and leucovorin 400 mg/m^(2) on day 1 and fluorouracil 400 mg/m^(2) on day 1, followed by 46-h continuous infusion of fluorouracil 2400 mg/m^(2)). After each treatment cycle, abdominal CT, tumor markers, and circulating tumor cell counts were reviewed to evaluate the treatment efficacy. All 15 patients achieved partial remission. The surgical procedures included laparoscopic pancreaticoduodenectomy(LPD, n = 8) and laparoscopic radical antegrade modular pancreatosplenectomy(L-RAMPS, n = 7). None of them were converted to a laparotomy. One patient with pancreatic head carcinoma was found to have portal vein involvement during the operation, and LPD combined with vascular resection and reconstruction was performed. The amount of blood loss and operation times of L-RAMPS vs LPD were 435.71 ± 32.37 m L vs 34

关 键 词：Pancreatic ductal adenocarcinoma Neoadjuvant chemotherapy Laparoscopic pancreaticoduodenectomy Laparoscopic radical antegrade modular pancreatosplenectomy COMPLICATIONS 

分 类 号：R735.9[医药卫生—肿瘤]