CAJ | 학술논문

胰头及壶腹周围恶性肿瘤恶性程度高、预后差。对于少数病变范围局限的患者，胰十二指肠切除术是唯一可能的治愈手段。胰十二指肠可切除性的评估标准相对统一，主要以肿瘤局部状况的评估为主，其中又以关键血管浸润及区域性淋巴结转移的评估最为关键。胰十二指肠可切除性的评估主要是通过以影像学检查为基础的多学科团队模式下的术前评估实现的，而其后进行的术中再评估将直接决定具体术式的选择。准确而客观的胰十二指肠可切除性的评估不仅能减少非治疗性开腹手术的发生、降低术后并发症率及死亡率、优化医疗资源的合理分配，而且更为重要的是能在真正意义上提高胰头及壶腹周围恶性肿瘤的根治性切除率及长期预后。
이두급호복주위악성종류악성정도고、예후차。대우소수병변범위국한적환자，이십이지장절제술시유일가능적치유수단。이십이지장가절제성적평고표준상대통일，주요이종류국부상황적평고위주，기중우이관건혈관침윤급구역성림파결전이적평고최위관건。이십이지장가절제성적평고주요시통과이영상학검사위기출적다학과단대모식하적술전평고실현적，이기후진행적술중재평고장직접결정구체술식적선택。준학이객관적이십이지장가절제성적평고불부능감소비치료성개복수술적발생、강저술후병발증솔급사망솔、우화의료자원적합리분배，이차경위중요적시능재진정의의상제고이두급호복주위악성종류적근치성절제솔급장기예후。
The proximal pancreatic and periampullary malignancy is highly vicious with poor prognosis.For patients with regional lesion , pancreaticoduodenectomy represents the only possibility of cure . The resectability of tumors seems to be relatively coincidental .The tumor-related factors , especially some key vessels compromised and/or lymph nodes metastases, are the mostly concerned.The preoperative assessment of resectability is mainly facilitated by imaging techniques and is guided by multi-disciplinary team therapy, whereas the intra-operative assessment would actually determine the exact procedure .Precise and objective assessment of resectability of proximal pancreatic and periampullary malignancy will not only minimize the incidence of non-curative laparotomy , lower the postoperative morbidity/mortality and optimize the allocation of medical resources , but also be important to actually elevate the curative resection rate and to ensure long-term prognosis .