[十二指肠狭窄的局部晚期不可切除胰腺癌十二指肠支架置入术后转换手术中的 R0 切除术病例]。

Yuta Iwai, Yuriko Fujita, Takeshi Takamoto, Tomohiro Fukuda, Satoshi Imamura, Yuya Tsunoda, Shuichi Nagakubo, Yuichi Morohoshi, Yuji Koike, Hirokazu Komatsu
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引用次数: 0

摘要

一名 67 岁的男子因呕吐来我院就诊。食管胃十二指肠镜检查发现十二指肠狭窄和非典型上皮。腹部造影剂计算机断层扫描(CT)发现胰头有一个肿瘤,大小约 30 毫米,涉及肠系膜上动脉和肠系膜上静脉。通过内镜活检,患者被确诊为局部晚期胰腺癌。由于十二指肠狭窄并发症,患者接受了十二指肠支架置入术。放置支架后,患者恢复了口服药物,全身情况好转后开始化疗(改良 FOLFIRINOX)。化疗后,CT 显示癌细胞进展和血管侵犯均有所减少。转换手术得到改善,实现了 R0 切除。我们的研究表明,十二指肠支架置入术可改善预后,因此被认为是多学科治疗的良好选择。
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[A case of R0 resection in conversion surgery after duodenal stent placement for locally advanced unresectable pancreatic cancer with duodenal stenosis].

A 67-year-old man presented to our hospital with vomiting. Esophagogastroduodenoscopy revealed duodenal stenosis and atypical epithelium. A tumor in the pancreatic head, about 30mm in size, involving the superior mesenteric artery and a superior mesenteric vein was identified using abdominal contrast computed tomography (CT). Locally advanced pancreatic cancer was diagnosed in the patient through an endoscopic biopsy. Due to the duodenal stenosis complication, duodenal stent placement was conducted. After stent placement, oral intake was resumed, and improvement of the systemic condition led to chemotherapy (modified FOLFIRINOX). After chemotherapy, CT revealed decreased carcinoma progression and vascular invasion. Conversion surgery was improved, and R0 resection was achieved. Our study showed that duodenal stent placement could enhance prognosis;as a result, it was regarded as a good choice for multidisciplinary therapy.

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来源期刊
Japanese Journal of Gastroenterology
Japanese Journal of Gastroenterology Medicine-Gastroenterology
CiteScore
0.20
自引率
0.00%
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0
期刊介绍: The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.
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