Distal resection of the pancreas in surgery for gastric cancer
Aim - the research was performed to determine the effect of distal pancreatectomy on immediate and long-term results of surgical treatment of gastric cancer. Material and methods. The paper summarizes the experience of 148 radical operations for gastric cancer combined with distal pancreatectomy. Results. The total mortality rate for 148 operations in gastric cancer and esophageal-gastric junction with distal pancreatic resection reached 6.1% (9 patients died). Three fatalities occurred in a very traumatic «non-standard» operations - total multicomponent transhiatal esophagogastrectomies with lymphodissection D2,5-D3. After percutaneous gastrectomy 6 patients out of 132 (4.5%) died in the hospital. All deaths were not directly related to an intervention on the pancreas. Conclusion. Based on the accumulated experience and the achieved results, the indications for distal resection of the pancreas in gastric cancer are: 1) veritable and false growth of a tumor into the pancreatic tissue, 2) technical inaccuracies in a surgical technique that has led to damage of tail of the pancreas. A relative indication could be a locally advanced cancer of the proximal stomach department with metastases in lymph nodes of pancreatolienal collector. In this case distal pancreatectomy should be performed as a component of left upper evisceration.