The Clinical Study On Simultaneous Resection Of Pancreatic Carcinoma With Synchronous Liver Metastases

Objective: To investigate the safety and prognosis of simultaneous resection of pancreatic carcinoma with liver metastases(PCLM).Methods: We retrospectively analyzed 27 pancreatic cancer patients with liver metastases who underwent simultaneous resection at Shengjing Hospital,from January,2012 to December,2017 and explored factors associated with prognosis.We evaluated the significance of simultaneous resection by comparison with 27 pancreatic cancer patients without liver metastases who underwent pancreatic resection and 20 pancreatic cancer patients with synchronous liver metastases who underwent palliative bypass alone.Results: Multivariate analysis for clinical features and therapeutic methods showed that the number of liver metastases,gamma-glutamyl transpeptidase(GGT)were prognostic variables with statistical significance.The survival time of PCLM patients who underwent simultaneous resection was worse than patients without liver metastases who underwent pancreatic resection[(5.3±0.5)months vs.(12.1±0.3)months,P<0.001],and the survival time was slightly longer than PCLM patients who underwent palliative bypass,but there was no significant difference[(5.3±0.5)months vs.(4.1±0.1)months,P=0.932].The operative time and postoperative infection rate of simultaneous resection group are more than the simple pancreatic resection group.There was no significant difference in intraoperative blood loss,complications,length of postoperative hospital stay between the two groups.The operative time,intraoperative blood loss,complications,length of postoperative hospital stay of patients who underwent simultaneous resection were more than who underwent palliative bypass.Conclusion: Simultaneous resection of pancreatic carcinoma with synchronous liver metastases can be performed safely,the prognosis of patients with low GGT and isolated liver metastases is relatively good.But simultaneous resection play a limited role in improving prognosis,and not obviously better than palliative bypass,and can not significantly improve the overall survival rate.