Challenges during pancreatoduodenectomy and ways to overcome them

F. Akhmetzyanov, A. Kotelnikov, M. D. Ter-Ovanesov, V. I. Egorov, T. D. Gostyunin, O. A. Karpeeva
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Abstract

Background. Pancreaticoduodenal resection (PDR) is the surgical procedure for cancer of the head of the pancreas, distal common bile duct, duodenum and ampulla of Vater. This surgery is associated with a high risk of complications, the development of which can be influenced by various factors. since pancreatic fistula is a key complication of PDR, the choice of the method for pancreatic anastomosis becomes especially important. Material and methods. The search for publications was carried out using the PubMed and Elibrary systems from January 1980 to January 2024. of the 2,300 sources found, 69 were used to write the review. We included data from both retrospective and prospective clinical trials that were devoted to pancreatoduodenectomy for malignant neoplasms, the difficulties encountered in performing this surgery and ways to solve them. Results. Currently, there are more than 60 types of pancreatico-digestive anastomosis, which indirectly indicates the absence of a universal one that ensures the prevention of pancreatic fistula. The treatment outcomes may be influenced by the nature of neoadjuvant treatment, concomitant diseases, anatomical features, presence of obstructive jaundice and methods of its relief. The main mechanisms of influence of negative factors on the development of complications are considered. an individual approach to the patient, taking into account all factors, can significantly reduce the risk of complications.
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胰十二指肠切除术中的挑战和克服挑战的方法
背景。胰十二指肠切除术(PDR)是治疗胰头癌、远端胆总管癌、十二指肠癌和瓦特氏门癌的外科手术。由于胰瘘是 PDR 的主要并发症之一,胰腺吻合方法的选择就变得尤为重要。材料和方法。我们使用 PubMed 和 Elibrary 系统对 1980 年 1 月至 2024 年 1 月期间的出版物进行了搜索。在找到的 2300 篇资料中,有 69 篇用于撰写本综述。我们收录了回顾性和前瞻性临床试验的数据,这些试验主要涉及恶性肿瘤的胰十二指肠切除术、实施该手术时遇到的困难以及解决这些困难的方法。结果。目前,胰十二指肠吻合术有 60 多种类型,这间接表明缺乏一种确保预防胰瘘的通用吻合术。治疗效果可能受到新辅助治疗的性质、并发疾病、解剖特征、是否存在阻塞性黄疸以及缓解方法的影响。考虑到所有因素,对患者采取个体化的治疗方法,可以大大降低并发症的风险。
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来源期刊
Siberian journal of oncology
Siberian journal of oncology Medicine-Oncology
CiteScore
0.40
自引率
0.00%
发文量
117
审稿时长
8 weeks
期刊介绍: The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets
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