关键词: 局部晚期胰腺癌, 新辅助治疗, 血管切除, 血管重建

Abstract: Related problems of locally advanced pancreatic cancer after neoadjuvant chemotherapy combined with vascular resection        MENG Ling-wei，WU Zhong，PENG Bing. Department of Pancreatic Surgery，West China Hospital，Sichuan University，Chengdu 610041，China
Corresponding author：PENG Bing，E-mail：pengbing84@
hotmail.com
Abstract    Locally advanced pancreatic cancer is generally considered initially unresectable due to invasion of adjacent major blood vessels ,  invasion of lymphatic and aggressive local growth along nerve sheath tissue. In recent years, neoadjuvant therapy provided more opportunities of radical resection for those patients. However，neoadjuvant therapy can lead to increased risk of  inflammation of local fibrous connective tissue in the tumor, which can lead to lack of good tissue gaps and increase the difficulty of surgery. Therefore, a comprehensive preoperative evaluation is a prerequisite for safe surgery, while different artery-first approaches, dissection of the anatomical triangle between the coeliac, superior mesenteric arteries and the portomesenteric vein, and radical antegrade modular pancreatosplenectomy are introduced to enhance the completeness of resection and reduce the risk of local recurrence. The advancement of surgical techniques and the wide application of vascular resection and/or reconstruction make it possible for patients with LAPC after neoadjuvant chemotherapy to achieve long-term prognosis.

Key words: locally advanced pancreatic cancer neoadjuvant therapy vasectomy vascular reconstruction