关键词: 胰腺癌, 新辅助化疗, 微创手术, 并发症, 预后

Abstract: Difficulties and strategies of laparoscopic pancreaticoduodenectomy after neoadjuvant therapy for pancreatic cancer        LI Zheng, YU Xian-jun, XU Xiao-wu.Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai Pancreatic Cancer Institute, Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China
Corresponding author：XU Xiao-wu，E-mail：xuxiaowu@
fudanpci.org
Abstract    Neoadjuvant chemotherapy is widely used in pancreatic cancer.Whether laparoscopic pancreaticoduodenectomy is safe and effective for pancreatic cancer patients after neoadjuvant chemotherapy has not been studied. After neoadjuvant chemotherapy, the inflammation of the fibrous connective tissue in the tumor may lead to a lack of good tissue gap and difficult dissection. Therefore, the difficulty of minimally invasive surgery is the resection process, while the reconstruction is relatively fixed and mature, and is rarely affected by neoadjuvant chemotherapy. After neoadjuvant chemotherapy, the tumor regression evaluated by imaging is not obvious, while the control of tumor biological indicators such as tumor markers is more important. The proportion of vascular resection and reconstruction is relatively high. However, with the high-definition and enlarged surgical field of 3D laparoscopy, the resection and reconstruction of the invaded vessels will no longer be difficult. Whether the long-term prognosis of laparoscopic pancreatoduodenectomy after neoadjuvant chemotherapy is different from that of open surgery needs to be verified by prospective, large sample, and multi center randomized controlled clinical trials.

Key words: pancreatic cancer, neoadjuvant chemotherapy, minimally invasive surgery, complication, prognosis