臨床外科72巻12号

2017年11月発行

特集 徹底解説！ここが変わった膵癌診療—新規約・ガイドラインに基づいて

新たな展開

国内外の臨床試験による新たなエビデンス

著者： 川井学¹ 山上裕機¹

所属機関： ¹和歌山県立医科大学第二外科

ページ範囲：P.1350 - P.1356

文献概要

【ポイント】
◆膵癌に対して拡大郭清は生存率に寄与しないだけでなく，術後合併症発生率を増加させる危険性がある．
◆膵頭十二指腸切除において主膵管拡張のないsoft pancreasでは，外瘻ステントがno stentより有意に臨床的膵液瘻を減少させた．
◆膵消化管吻合における膵腸吻合と膵胃吻合の膵液瘻減少における優劣性はいまだ確立されておらず，今後は長期成績も比較検討する必要がある．
◆膵体尾部切除における膵断端閉鎖は，自動縫合器に比較して自動縫合器＋補強材が有意に臨床的膵液瘻を減少させた．

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