动脉预阻断技术在局部进展期胰腺癌手术中应用OA

Locally advanced pancreatic cancer(LAPC)accounts for approximately 30％of newly diagnosed pancreatic cancer cases,with arterial involvement representing the foremost surgical barrier to curative resection.The recent progress in neoadjuvant therapy has rendered an increasing subset of these patients eligible for conversion surgery;nevertheless,the post-conversion procedure frequently remains encumbered by dense tumor adherence to major arterial walls.Arterial sheath resection-achieving R0 clearance via meticulous dissection along the anatomical plane between the adventitia and the external elastic lamina without sacrificing the underlying artery-has emerged as the preferred approach for managing arterial-involved LAPC.Based on this foundation,the arterial prophylactic occlusion technique(APOT)enhances the safety of sheath dissection through intraoperative temporary and graded flow control of the affected artery.APOT is indicated during arterial sheath dissection after neoadjuvant therapy;by providing graded temporary flow control,it can shorten operative time,reduce blood loss,achieve an R0 resection rate of 85.7％,and does not increase complications.