Abstract
Malignant tumors of the body and tail of the pancreas account for about 20% of all malignant tumors of the pancreas. The early clinical symptoms of the tumors are mainly abdominal and back pain and weight loss. The symptoms and signs are not obvious or specific. At the time of consultation, the tumors often metastasize and invade the main peripancreatic vessels, which mainly include the abdominal trunk, the common hepatic artery, and the splenic artery and vein, etc. The resectability rate of these tumors is low. The 2-year survival rate was only 10%, the median survival time was 9.8 months, and the prognosis was very poor [1]. In the past, it was considered that the tumors invaded the abdominal trunk could not be resected. But with the advancement of pancreatic surgery technology, the modified Appleby operation was applied to the treatment of pancreatic body and tail malignant tumors invading the common hepatic artery and abdominal trunk, which provided patients with the opportunity of operation, improved the resection rate of R0, effectively prolonged the survival time of patients, and improved the quality of life of patients.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Yamamoto Y, Sakamoto Y, Ban D, et al. Is celiac axis resection justified for T4 pancreatic body cancer? Surgery. 2012;151:61–9.
Appleby LH. The coeliac axis in the expansion of the operation for gastric carcinoma. Cancer. 1953;6(4):704–7.
Hishinuma S, Ogata Y, Tomikawa M, et al. Stomach-preserving distal pancreatectomy with combined resection of the celiac artery: radical procedure for locally advanced cancer of the pancreatic body. J Gastrointest Surg. 2007;11(6):743–9.
Hirano S, Kondo S, Hara T, et al. Distal pancreatectomy with en bloc celiac axis resection for locally advanced pancreatic body cancer: long-term results. Ann Surg. 2007;246(1):46–51.
Greer J, Zureikat AH. Robotic distal pancreatectomy combined with celiac axis resection. J Vis Surg. 2017;3:145.
Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic Adenocarcinoma, Version 2.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw. 2017;15(8):1028–61.
Wolfgang CL, Herman JM, Laheru DA, et al. Recent progress in pancreatic cancer. CA Cancer J Clin. 2013;63(5):318–48.
Nakamura T, Hirano S, Noji T, et al. Distal Pancreatectomy with en bloc celiac Axis resection (modified Appleby procedure) for locally advanced pancreatic body cancer: a single center review of 80 consecutive patients. Ann Surg Oncol. 2016;23:969–75.
De Rooij T, Tol JA, van Eijck CH, et al. Outcomes of distal pancreatectomy for pancreatic ductal adenocarcinoma in the Netherlands: a nationwide retrospective analysis. Ann Surg Oncol. 2016;23(2):585–91.
Cesaretti M, Abdel-Rehim M, Sauvanet A. Modified Appleby procedure for borderline resectable/locally advanced distal pancreatic adenocarcinoma: a major procedure for selected patients. J Visc Surg. 2016;153:173–81.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Zhang, QF. (2020). Modified Appleby Operation for Advanced Malignant Tumors of the Body and Tail of the Pancreas. In: Liu, Yb. (eds) Surgical Atlas of Pancreatic Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-32-9864-4_9
Download citation
DOI: https://doi.org/10.1007/978-981-32-9864-4_9
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-32-9863-7
Online ISBN: 978-981-32-9864-4
eBook Packages: MedicineMedicine (R0)