Surgical treatment of pancreatic cancer

If pancreatic cancer is diagnosed early and there is no obvious metastasis or spread of the lesions, surgical treatment can be performed. Preoperative preparation should be done before surgical treatment, and different surgical methods can be used depending on the location and extent of the tumor.

Preoperative preparation

If there is severe jaundice and abnormal liver function, and surgery cannot be performed in time, biliary drainage can be performed first to reduce jaundice and improve liver function. In the past, cholecystostomy was often performed first, followed by a second-stage operation. Now, percutaneous transhepatic biliary drainage (PTCD) can be performed first, and radical surgery can be performed within a time limit according to the improvement of liver function. For those who drain a large amount of bile every day, patients should be encouraged to drink the drained bile in several times, supplemented with a high-nutrition diet to better improve nutritional status and prepare for further treatment.

Surgical method

1. Radical surgery: Depending on the location of the tumor, it can be roughly divided into pancreaticoduodenectomy, pancreatectomy and total pancreatectomy. Generally speaking, pancreatic surgery is a relatively large operation, which requires high technical level and experience of the surgeon, as well as pre- and post-operative treatment. If possible, it should be performed in a hospital with a large number of pancreatic surgeries.

2. Pancreatic cancer surgery combined with vascular resection: In the past, it was believed that tumor invasion of the portal vein and superior mesenteric vein was a contraindication to surgical resection, resulting in a low surgical resection rate. In recent years, with the strengthening of preoperative and postoperative treatment and the improvement of surgical techniques, this situation is no longer a contraindication to surgical resection, and the goal of complete tumor resection can be achieved through vascular resection and reconstruction. The surgical treatment effect of these patients is the same as that of patients without vascular involvement.

3. Surgical treatment for unresectable pancreatic cancer: For patients who are not suitable for radical surgical resection due to tumor or physical reasons, appropriate surgical intervention may have a significant effect on prolonging the patient's survival and improving the quality of life. In this case, common surgical intervention measures include gastrointestinal anastomosis and choledochojejunostomy. It should be emphasized that with the development of medicine, the application of duct stent technology is becoming more and more widespread, and the number of patients who undergo palliative choledochojejunostomy due to bile duct obstruction alone has been significantly reduced.