Analysis Of Pancreatoduodenectomy Combined With SMV/PV Resection For The Treatment Of Pancreatic Cancer

Purpose:The effect and safety of pancreaticoduodenectomy in the treatment of pancreatic cancer combined with SMV/PV resection and reconstruction were analyzed,and the short-term outcome providedreference for the selection of proper surgicai treatmentMethod:With Meta analysis,Application of computer-based retrieval of Chinese and English databases for clinical trials of pancreaticoduodenectomy combined with resection and reconstruction of pancreatic cancer.10 controlled trials were randomly selected to carry out comprehensive quantitative analysis.Finally,10 studies were included,containning 5 Chinese literatures and 5 English literatures.The total number of cases was 2989,of which,there were 959 cases of pancreatoduodenectomy combined with SMV/PV resection and reconstruction,and 2030 cases without SMV/PV resection and reconstruction.Result:The results of meta-analysis showed that the operation time of pancreaticoduodenectomy combined with SMV/PV resectionan was longer than that of pancreaticoduodenectomy without vein resection.The amount of bleeding in pancreatoduodenectomy combined with SMV/PV resection was larger than that without vein resection;The incidence of postoperative complications combined with SMV/PV resection was higher than that without vein reconstruction.The difference was significant heterogeneity(P<0.05);The 5 years survival rate of pancreaticoduodenectomy combined with SMV/PV resection was lower than that of pancreatoduodenectomy without vein resection.The R0 resection rate of pancreaticoduodenectomy combined with SMV/PV was higher than that of pancreatoduodenectomy without vein resection.The tumor diameter in the group of vein was greater than that without vein resetion;There was no significant difference in perioperative mortality between pancreaticoduodenectomy combined with SMV/PV resection and pancreatoduodenectomy without vein reconstruction;There was no significant difference in the 1-year and 3-year survival rate between the two groups.Conclusion:Although,the opearationg time,the amount of bieeding,and complications were increased in the pancreatoduodenectomy combined with SMV/PV resection,There was no significant difference in the perioperative mortality rate,and the RO rate was significantly higher.When tumors invade SMV/PV,after careful consideration of the high incidence of complications associated with pancreatoduodenectomy combined with SMV/PV resection,a pancreaticoduodenectomy with SMV/PV cresection was performed to increase the RO resection rate and It is feasible to prolong patient survival.