Rational Dissection of Lymphatic and Nervous Tissue in Curative Resection for Pancreatic Cancer

Keiichiro Kanemitsu, Takehisa Hiraoka, Tastuya Tsuji, Tetsuro Morisaki, Nobuo Kitamura

First Department of Surgery, Kumamoto University School of Medicine

Rational dissection of lymphatic and nervous tissue in curative resection for pancreatic cancer was studied on 46 patients with extended operation, containing 35 patients with IORT and 15 patients with tsl tumor. Lymph node involvement and extrapancreatic nerve plexus invasion were found in 80% and 66.7% of patients with extended operation, respectively. Curative resection rate of these cases was 71%. Five year survival rates of 35 patients with IORT and patients with stage IVa tumor were 16.8% and 18.9%, respectively. Patients with stage IVb tumor or n2 lymph node involvement died within one year. At autopsy, control of local recurrence was improved in patients with IORT. Patients with small tumor within 1 cm in diameter had good prognosis by standard operation. For tumor within 1 cm, standard operation may be indicated. Extended operation with IORT should be performed for tumor over 1 cm to stage IVa tumor and should not be done for tumor of stage IVb or with n2 lymph node involvement.

Key words
pancreatic cancer, extended operation, rational dissection

Reprint requests
Keiichiro Kanemitsu First Department of Surgey, Kumamoto University School of Medicine
1-1-1 Honjo, Kumamoto City, 860 JAPAN

Accepted
July 2, 1997

To read the PDF file you will need Abobe Reader installed on your computer.