Analysis Of The Curative Effect Of Distal Pancreatectomy Combined With Celiac Axis Resection In Treatment Of Carcinoma Of The Body/Tail Of The Pancreas

Objective: Few comparison studies have been carriedout on patients with distal pancreatectomy combined with celiac axis(CA)resection.The aim of this study was to assess the safety and efficacy of this extended procedure in treatment of advanced carcinoma of the body/tail of the pancreas..Methods: This was a retrospective analysis of125 patients with carcinoma of the body/tail of the pancreas from January 2013 through December2016.Patients were divided into three groups based on the relationship of tumor and CA/ common hepatic artery(CHA)as well as different treatment strategies.Data for operation time,blood loss,complications,quality of life and survival time were collected and statistically analyzed.Results: Fifty-two patients(41.6%)received radical distal pancreatectomy,including 17 patients who underwent radical antegrade modular pancreatosplenectomy(RAMPS)combined with celiac axis resection(group A)and35patients who received RAMPS(group B).Nineteen patients did not undergo distal pancreatectomy because of CA and/or CHA invasion only(group C).Group A had longer Postoperative hospital days than group B(29 versus 18 days,P = 0.003);there was no difference in operation time,blood loss,pancreatic fistula,delayed gastric emptying and whether or not the pain is relieved.However,group A had significantly prolonged median survival time compared with the 20 patients in group C(8.3 versus 5 months),Whether or not the pain is relieved is also statistically significant(P<0.001).Conclusion:Distal pancreatectomy combined with CA resection can be safely and effectively performed in certain patients with carcinoma of body/tail of the pancreas.It significantly increasesresectability,improves quality of life,and probably prolongs overall survival in this group of advanced-stage pancreatic cancer patients.