Radical resection for pancreatic cancer

Pancreatic cancer is usually discovered when jaundice appears, and pancreatic body and tail cancer is usually discovered when back pain or a mass is felt. Most of them are in the middle or late stages, and the surgical resection rate is low. Even if surgical resection is performed, few can achieve true histological radical resection. In the comprehensive treatment of unresectable pancreatic cancer, in addition to surgical treatment to relieve obstructive jaundice and duodenal obstruction, there are other therapies such as chemotherapy, radiotherapy, and immunotherapy, which are also suitable for comprehensive treatment after surgery and have a certain effect on improving the efficacy.

(1) Extracorporeal drainage for biliary obstruction For the elderly, the weak, those with hypoproteinemia, biliary infection, or those with poor liver and kidney function who cannot tolerate bile duct drainage, external drainage via bile duct or cholecystostomy can be performed. The operation is simple and has few complications, but a large amount of bile loss may cause water and electrolyte disorders and malnutrition. If conditions permit, jejunostomy and extracorporeal bridging can be performed at the same time to allow bile to enter the intestine.

(2) Cholecystojejunostomy (internal drainage) is a commonly used procedure in clinical practice. As long as the patient is in good physical condition and can be expected to tolerate the procedure, cholecystojejunostomy (internal drainage) should be listed as the preferred procedure.

(3) Gastrojejunostomy It is generally believed that the following clinical situations should be treated with gastrojejunostomy: ① Symptoms or signs of duodenal obstruction. ② Gastrointestinal X-ray or endoscopic examination shows stenosis, stiffness, and tumor infiltration of the duodenum. ③ Stenosis and compression of the duodenum are found during the operation. Gastrojejunostomy can relieve obstruction symptoms and improve the quality of life.