Author/Editor		Pegan, Vladislav
Title		Rak trebušne slinavke - Radikalno kirurško zdravljenje
Translated title		Cancer of the pancreas - Resectional therapy
Type		članek
Source		Gastroenterolog
Vol. and No.		Letnik 5, št. 1
Publication year		2001
Volume		str. 31-43
Language		slo
Abstract		Every year in Slovenia we can expect about 50 patients with pancreatic cancer suitable for radical surgical treatment. Because of the fact that 60 to 70% of pancreatic cancer is located in the head of the gland the pancreatoduodenectomy is the predominant surgical procedure. This is true also according to very low resectability of malignant tumours located elsewhere in the gland. A safe performance of pancreatoduodenectomy is warranted in the hands of skilled and experienced surgical team. A prerequisite for the good result of this operation is a low incidence of postoperative morbidity and a postoperative mortality below 5%. Mastering with all operative modalities the surgeon will be able, to achieve this goal. Performing the best operative variety he will contribute to a quick convalescence of the patient. The duration of the operation in the era of modern anaesthesia does not seem to influence the outcome. Yet the radical removal of all malignant tissue is of paramount importance for longer survival. Total pancreatectomy is only exceptionaly indicated. Howewer, multicentricity of cancer growth, indeed very rare, is probably the unique indication for this highly mutilating procedure. The total pancreatectomy does not contribute to lower postoperatve complication rate, neither has a beneficial effect in terms of longer survival due to imagined advantage in radicality.
Summary		V Sloveniji pričakujemo letno največ 50 bolnikov z rakom trebušne slinavke, pri katerih bo možno radikalno kirurško zdravljenje. Ker je v 60 do 70% z rakavim tkivom prizadeta glava trebušne slinavke, je pankreatoduodenektomija prevladujoča operacija pri raku trebušne slinavke. Žal tudi zato, ker je operabilnost pri drugih lokalizacijah bistveno manjša. Varno lahko izvede to operacijo le dobra izurjena in izkušena skupina zdravnikov in drugih zdravstvenih delavcev Pogoj za dober rezultat sta majhna pooperacijska obolevnost in pooperacijska smrtnost, manjša od 5%. Da bi zmanjšal obolevnost in pooperacijsko smrtnost, mora operater poznati celo vrsto tehničnih različic. Od uporabe najprimernejše bo odvisno tudi hitro okrevanje bolnika po operaciji. Trajanje operacije ob sodobni anesteziji ne vpliva na rezultat operacije, je pa naloga operaterja, da si prizadeva odstraniti maligno tkivo v celoti, kar je eden od pogojev za dolgo pooperacijsko preživetje. Totalna pankreatektomija je potrebna le izjemoma. Multicentričnost malignega procesa je ena od nedvoumnih indikacij, je pa na srečo izredno redka. Sicer pa popolna odstranitev žleze v ničemer ne pripomore k zmanjšanju pooperacijskih zapletov; kakor tudi ne prispeva k podaljšanju preživetja zaradi domnevno temeljitejše radikalnosti.
Descriptors		PANCREATIC NEOPLASMS PANCREATICODUODENECTOMY PANCREATECTOMY