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[Indications and surgical technique of Appleby's operation for tumor invasion of the celiac trunk and its branches]. / Intervention d'Appleby: place et technique en cas d'envahissement tumoral du tronc coeliaque et de ses branches.
Bonnet, S; Kohneh-Shahri, N; Goere, D; Deshayes, I; Ayadi, S; Elias, D.
Afiliação
  • Bonnet S; Département de chirurgie générale oncologique, institut Gustave-Roussy, 39, rue Camille-Desmoulins, 94805 Villejuif cedex, France.
J Chir (Paris) ; 146(1): 6-14, 2009 Feb.
Article em Fr | MEDLINE | ID: mdl-19446687
Cancerous invasion of the celiac trunk is usually considered a contraindication to attempts at curative resection. Appleby was the first to propose an en bloc resection of the celiac trunk along with the celiac nervous plexus and lymph nodes for advanced gastric cancer. We describe a "modified Appleby technique" without gastrectomy for locally advanced cancer of the body of the pancreas. It accomplishes radical tumor resection, relieves pain, and improves the quality of life and overall prognosis. The principal complications are pancreatic fistula and gastric ischemia. Preoperative embolization of the common hepatic artery helps to develop favorable collateral blood flow and to avoid ischemia of the hepatobiliary system. A stomach-preserving" Appleby resection" may be appropriate treatment for selected nonaggressive cancers of the midpancreas; preoperative embolization of the common hepatic artery is an important adjunct of this technique.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pancreatectomia / Neoplasias Pancreáticas / Adenocarcinoma / Artéria Celíaca Aspecto: Patient_preference Limite: Humans Idioma: Fr Revista: J Chir (Paris) Ano de publicação: 2009 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Pancreatectomia / Neoplasias Pancreáticas / Adenocarcinoma / Artéria Celíaca Aspecto: Patient_preference Limite: Humans Idioma: Fr Revista: J Chir (Paris) Ano de publicação: 2009 Tipo de documento: Article