Feasibility and efficacy of distal pancreatectomy with en bloc celiac axis resection (DP-CAR) for locally advanced pancreatic body cancer

Abstract

s / Pancreatology 12 (2012) 502–597 523 Methods: 153 patients with chronic pancreatitis (CP) were included in the research in whom pancreas proximal resections were performed (pancreatoduodenal resection in 53 patients; Beger operation in modification of the clinic – in 61 patients; Bern modification – in 39 patients). Criteria of treatment efficacy were the level of distant lethality, frequency of complications and repeated interventions, marked character of exocrine and endocrine insufficiency. The pain syndrome level and professional rehabilitation of patients were estimated. Results: Late lethality related to chronic pancreatitis progressing made up 2,61%. Firstly revealed diabetes mellitus developed in 15 (9,8%) patients after all surgical interventions; reliably smaller number of such cases in patients after Beger operation was noted in comparison with pancreatoduodenal resection. Exocrine insufficiency was revealed in 27 (17,65%) patients and it doesnt depend on the operative technique. High level of professional rehabilitation was marked at all techniques which was achieved in 137 (89,54%) patients. There was a reliable improvement of parameters of the pain syndrome elimination after Beger operation in modification of the clinic in comparison with pancreatoduodenal resection. Conclusions: The performed analysis of the distant results of surgical treatment of CP patients demonstrates advantages of the pancreas proximal resection with the duodenum saving.