胰腺全系膜切除的进展与评价

Progress and assessment of total mesopancreas excision of pancreas

  • 摘要: 胰腺系膜不同于结直肠系膜,其无纤维组织鞘包裹,内含淋巴、神经、血管、脂肪等组织,在范围、边界等方面存在争议。有限的临床研究结果表明:胰腺全系膜切除(TMpE)可提高R0切除率,但均为单中心回顾性研究,尚难以评价其对患者预后的改善作用。TMpE与既往扩大切除或清扫在手术范围方面的异同也需要深入评价。提倡开展针对TMpE的解剖学及临床研究,并借此规范手术切除范围,使患者最大获益。

     

    Abstract: As no fiber sheath covered, mesopancreas is considered to be different from mesocolon and mesorectum. Though amount of lymphatic, nervous, vascular and fat tissues are consisted in this structure, the margin and range are still controversial in the clinical practice. Only a few clinical reports show a higher R0resection rate with the procedure of total mesopancreas excision (TMpE), but most of the studies are single-centered and retrospective, from which we could not assess the outcome improvement for the patients undergoing TMpE. More-over, the difference between the ranges of TMpE and ever-used extended excision or lymphectomy should be further evaluated. More anatomical and clinical studies are needed to standardize the operation range in order to benefit the patients.

     

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