Evolution of surgery for pancreatic head and periampullary cancer
https://doi.org/10.16931/1995-5464.2019345-53
Abstract
Development of surgical approach for pancreatic head and periampullary cancer at the Blokhin National Medical Research Center of Oncology over the past 30 years and global surgical tendencies of surgery for pancreatic cancer are demonstrated in the article. Over this period, gastropancreaticoduodenectomy has evolved from standard procedure without complete lymph node dissection and neurodissection and extended gastropancreaticoduodenectomy with obligatory circular skeletonization of superior mesenteric artery and para-aortic lymphadenectomy to standard gastropancreaticoduodenectomy. The last procedure implies mandatory skeletonization of the right semicircle of superior mesenteric artery, all tubular structures of hepatoduodenal ligament and possible resection of portal and superior mesenteric vein for suspected invasion. Surgical possibilities in the treatment of patients with pancreatic head and periampullary cancer are exhausted. The concept of “early diagnosis” is not applicable for patients with ductal pancreatic cancer. Further progress is exclusively associated with medicamentous combined treatment based on the molecular-biological characteristics of pancreatic and periampular cancer and, possibly, with primary prevention of pancreatic cancer.
About the Authors
Yu. I. Patyutko
Blokhin National Medical Cancer Research Center of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Yury I. Patyutko – Doct. of Sci. (Med.), Professor, Chief Research Fellow of the Surgical Department of Liver and Pancreatic Tumors
yurij-patyutko@yandex.ru
A. G. Kotelnikov
Blokhin National Medical Cancer Research Center of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Aleksey G. Kotelnikov – Doct. of Sci. (Med.), Professor, Leading Research Fellow of the Surgical Department of Liver and Pancreatic Tumors
24, Kashirskoye shosse, Moscow, 115478. Phone: +7-903-199-18-88
A. N. Polyakov
Blokhin National Medical Cancer Research Center of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Aleksandr N. Polyakov – Cand. of Sci. (Med.), Senior Research Fellow of the Surgical Department of Liver and Pancreatic Tumors
24, Kashirskoye shosse, Moscow, 115478. Phone: +7-903-588-24-64
V. D. Podluzhnyi
Blokhin National Medical Cancer Research Center of the Ministry of Health of the Russian Federation
Russian Federation
Danila V. Podluzhnyi – Cand. of Sci. (Med.), Head of the Surgical Department of Liver and Pancreatic Tumors
Russian Federation
Danila V. Podluzhnyi – Cand. of Sci. (Med.), Head of the Surgical Department of Liver and Pancreatic Tumors
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Review
For citations:
Patyutko Yu.I., Kotelnikov A.G., Polyakov A.N., Podluzhnyi V.D. Evolution of surgery for pancreatic head and periampullary cancer. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2019;24(3):45-53. (In Russ.) https://doi.org/10.16931/1995-5464.2019345-53
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