| 抄録 |
Aims:Neoadjuvant chemotherapy (NAC) may lead to successful margin-negative resection (R0) in patients with borderline resectable pancreatic head cancer (BRPHC). To evaluate the efficacy of and complications associated with the use of covered self-expanding metal stent (CSEMS) during NAC and the surgical period. Methods:We reviewed the outcomes of patients of BRPHC and divided the patients chronologically, in terms of the period of stent placement, into three groups: group A; plastic stent deployment between April 2006 and July 2008; group B; plastic stent deployment plus NAC between August 2009 and October 2010; group C; CSEMS deployment plus NAC between November 2010 and Janualy 2012. Safe R0 surgery was defined as R0 surgery without the need for repeat ERCP intervention or postoperative complications. Results: There were a total of 39 patients with BRPHC (groups A, B and C: 12, 11and 16 patients, respectively). The stent patency periods in groups A, B and C were 25, 59 and 115 days, respectively (p＜0.05). The rates of achievement of R0 surgery in groups A, B and C were 67% (8/12), 100% (11/11) and 88% (14/16), respectively. The rates of achievement of safe R0 surgery in groups A, B and C were 25% (3/12), 36% (4/11) and 75% (12/16), respectively (p＜0.05). Conclusions: Insertion of a CSEMS should be considered for the relief of biliary obstruction in patients with BRPHC scheduled to receive NAC, in view of the superior biliary patency rate, lower re-intervention rate for recurrent biliary obstruction, and a potentially high rate of achievement of safe R0 surgery. |
