26RPD Cases With Arterial Priority Processing Case Analysis

ObjectiveStudy on Arterial priority processing in pancreatic head carcinoma invasion of theportal vein/SMV of the radical pancreaticoduodenectomy advantage.MethodsWe retrospectively collected pancreaticoduodenectomy pancreatic resection from June2012to May2013treated by Arterial priority processing with portal vein/SMV invasion ofcarcinoma of head of pancreas in26cases. Including preoperative imaging data,intraoperative data and postoperative laboratory results. And we used the conventionalmethod of pancreatoduodenectomy were compared in various aspects, and calculate the Pvalue, the difference between the obtained, assessment of Arterial priority processingadvantages.ResultsIn the operation,26patients had no operation death, the average operation time was318min (245~400min), the average intraoperative blood loss was350ml (250~600ml).In the complication, pancreatic fistula in2cases (2/26,7.6%); postoperative hemorrhage in2cases (2/26,7.6%);1cases of delayed gastric emptying (1/26，3.8%); the overallcomplication rate was19.2%. There will be no infringement of the venous system usingArterial priority processing method of radical pancreaticoduodenectomy (B group)compared with conventional method(C group), pancreatic fistula6.3%(1/16) vs the1.6%(5/306), P=0.205, the mortality rate was0%(0/16) vs1.0%(3/306) P=0.859, postoperativehemorrhage (0/16) vs3.3%(10/306), P=0.606, gastric emptying0%(0/16) vs1.0%(3/306), P=0.859, total complication rate was6.3%(1/16) vs6.9%(21/306), P=0.703, averagebleeding was250ml vs in550ml, P=0.039.ConclusionArterial priority processing in radical pancreaticoduodenectomy can reduce the amountof bleeding during the operation, and not increase postoperative complications, provides asafe and effective operation method for clinical surgeons in the treatment of pancreatic headcarcinoma invasion of the portal vein/SMV. It has unique advantages in ensuring operationsafety, so it is recommended to use.