CRYOABLATION USAGE IN SURGICAL TREATMENT OF PANCREATIC TUMORS WITH INVASION OF MAJOR VESSELS

Abstract

Surgical treatment of pancreatic cancer is one of the most challenging problems in modern pancreatology. This work is based on the analysis of the results of examination and treatment of patients with malignant tumors of the pancreas with invasion of the major vessels for the period from 2004 to 2014. The criteria for inclusion in the study were patients with malignant tumors of the pancreas with invasion of the major vessels that are diagnosed via instrumental and morphological methods. The study includes 22 patients who underwent resection of the pancreatic cancer with cryodestruction of the residual tumor on the vessel. In all 22 cases ductal adenocarcinoma of the pancreas was diagnosed, which was represented by different degrees of differentiation. Application of cryoablation made it possible to achieve, 1-, 3- and 5-year survival rates respectively 73%, 41% and 18%, median - 26 months. In the postoperative period 2 (9.1%) patients died. In the first year of life after surgical treatment 6 patients died; the third year - 4 patients, 3 continue to live (17, 16, 17 months), in the period between 3 and 5 years 4 patients died, one lives; 4 patients survived for 5-year period, including one patient alive (106 months). In the study of quality of life at 6 months after surgery, 6 (27%) patients rated their condition as 100% of the Karnovskiy index, which means no complaints and symptoms, 7 (32%) patients as 80-90%, 4 as 70% and 5 patients (22%) as 30%.Cryoablation of the vessel's wall allows to reduce the number of postoperative complications, extends the indications for use of resection techniques, leading to improvement of survival rate of the patients (1-, 3- and 5- year survival rate: 73%, 41% and 18%).

Keywords

• tumors of the pancreas, cryoablation, tumor's invasion in major vessels.