Total Pancreatectomy Combined with Partial Pancreas Autotransplantation for Recurrent Pancreatic Cancer: A Case Report
Total Pancreatectomy Combined with Partial Pancreas Autotransplantation for Recurrent Pancreatic Cancer: A Case Report
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DOI：
10.1016/j.transproceed.2012.03.016
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发表时间：
2012-05-01
影响因子：
0.9
通讯作者：
Hatakeyama, K.
中科院分区：
文献类型：
--
作者：
Kobayashi, T.;Sato, Y.;Hatakeyama, K.
我们描述一位因胰头浸润性导管癌接受保留幽门的胰管切除术后3年出现可切除的残胰癌的病人。我们还进行了远端胰腺自体移植，使用切除的胰腺的一部分，以保护内分泌功能。最终的组织学结果显示第二个肿瘤是一个浸润性导管癌，由分化良好的管状腺癌组成，其组织病理学结果与第一个肿瘤相似。没有显微镜下淋巴结转移，也没有微血管浸润的证据（根据国际抗癌联盟TNM分类，pStage IA [pT 1，pN 0，MO]和R 0）。患者在术后20天出院，无任何问题，随后接受S-1辅助化疗。第二次手术后，碳水化合物抗原19-9值再次正常化。第二次手术后20个月，患者存活，无癌症复发。胰腺移植物功能正常，血糖为108 mg/dL，HbA 1C为6.2%，血清C肽为1.4 ng/mL。
We describe a patient presenting with a resectable carcinoma of the remnant pancreas at 3 years after undergoing a pylorus-preserving pancreaticoduodenectomy for invasive ductal carcinoma of the pancreatic head. We also performed a distal pancreas autotransplantation using a part of the resected pancreas to preserve endocrine function. Final histologic findings showed the second tumor to be an invasive ductal carcinoma consisting of a well-differentiated tubular adenocarcinoma with similar histopathologic findings as the first tumor. There were no microscopic lymph node metastases and no evidence of microvascular invasion (pStage IA [pT1, pN0, MO] and R0 according to the International Union Against Cancer TNM classification). The patient was discharged at 20 days after surgery without any trouble and followed by adjuvant chemotherapy with S-1. The carbohydrate antigen 19-9 value was again normalized after the second surgery. Twenty months after the second operation, the patient is alive without cancer recurrence. The pancreas graft is functioning with a blood glucose of 108 mg/dL, HbA1C of 6.2%, and serum C-peptide of 1.4 ng/mL.