Prevention of complications of pancreatoduodenal resection in pancreatic cancer

Abstract

Introduction. Over the past few decades, the incidence of pancreatic cancer has dramatically increased worldwide. Despite the high prevalence of this oncological pathology, there is currently no consensus on the expediency of performing radical reconstructive-plastic surgeries in case of malignant pancreatic tumors.
 Aim: to study the influence of reconstructive-plastic techniques of surgical treatment of pancreatic cancer on the life expectancy of patients and its quality.
 Materials and methods. Analysis of the short and long-term outcomes of surgical treatment of pancreatic cancer was conducted. In total, radical operative interventions were carried out in 32 patients, including 14 men (56.25%) and 18 women (43,75%), aged 37 to 72 (61,5±10,0) years. Pyloro-preserving pancreatoduodenal resection was performed in 20 (62.5%) patients, gastropancreatoduodenal resection — in 6 (18.8%) patients, proximal resection — in 5 (15.6%) patients, distal pancreatic resection — in 1 case (3,1%). Areflux pancreatojejunal anastomosis was formed in patients by the clinic technique.
 Results. Hospital mortality was 6.25%. More than three years after surgery, 15.6% of patients are alive; the median survival rate is 19.5±2.4 months. An assessment of the quality of life and the function of the formed pancreatojejunostomy conducted in the immediate and remote periods showed that the presence of areflux valve reliably prevents the development of pancreatic stump, providing a high level of quality of life for patients.
 Conclusions. The use of organ-preserving and organ-modulating techniques in the treatment of operable pancreatic cancer does not affect survival, but provides an acceptable level of quality of life for patients in the short and long-term perspective after surgery.