Overview
In the distal pancreatectomy (including pancreatic tail resection) for invasive ductal carcinoma of the pancreas, we evaluate the usefulness of a procedure of firstly transection of splenic arteries and veins (the isolation procedure group) compared to a conventional procedure of transection of the splenic vein at the end.
Eligibility
Inclusion Criteria:
- Resectable pancreatic cancer (Adenocarcinoma, adenosquamous cell carcinoma, mucinous carcinoma, and anaplastic carcinoma according to the 7th edition of the regulations for handling pancreatic cancer)
- ASA-PS (American Society of Anesthesiology, General condition classification) is Class 1-3.
- Age are over 20 years old.
- Able to understand the content of the research and has obtained written consent from the person himself/herself.
Exclusion Criteria:
- Non-resectable pancreatic cancer by image diagnosis at the initial diagnosis
- Cases suspected of portal vein (superior mesenteric vein) invasion
- Patients with severe ischemic heart disease
- Patients with cirrhosis or active hepatitis requiring treatment
- Patients with dyspnea requiring oxygen administration
- Patients undergoing dialysis due to chronic renal failure
- Cases in which arterial reconstruction of the superior mesenteric artery, common hepatic artery, celiac artery, etc. is considered necessary
- Patients with strong suspected paraaortic lymph node metastasis
- Active double cancer thought to affect adverse events and prognosis
- Long-term oral steroids that may affect adverse events
- Patients who are considered to have difficulty participating in the study due to psychosis or psychiatric symptoms.
- Cases other than invasive pancreatic ductal carcinoma by preoperative biopsy. Invasive intraductal papillary mucinous carcinoma (IPMC) is excluded.
- Patients who cannot use both iodine drugs and gadnium drugs due to severe drug allergy
- Cases where the prescribed procedure is difficult due to history of upper abdominal surgery such as stomach, spleen, kidney, liver, transverse colon, retroperitoneum including pancreas and pancreatitis