Pancreatic Resection Clinical Trial
Official title:
Per-operative Exploration of the Peri-pancreatic Lymphatic Pathways During Pancreatic Surgical Resection
Short description of the protocol intended for the lay public. Include a brief statement of
the study hypothesis (Limit : 5000 characters) Pancreatic cancer has a poor prognosis.
Surgical resection is the only curative treatment. Major pancreatectomies lead to high
postoperative morbidity rate, up to 30%. For some tumors, limited resection are increasedly
performed, but the rate of pancreatic fistula is even higher, up to 40%.
No precise "anatomic" pancreatic segmentation currently exists. If such segmentation is
described, pancreatic resections, major of minor, may have better outcomes.
The aim of this study is to demonstrate the existence of independent pancreatic segments,
following the lymphatic drainage of the gland.
Extended description of the protocol, including more technical information (as compared to
the Brief Summary) if desired. Do not include the entire protocol; do not duplicate
information recorded in other data elements, such as eligibility criteria or outcome
measures. (Limit : 32 000 characters) The prognosis and life expectancy for people with
pancreatic cancer remain very low (3rd cause of mortality among all cancer). Surgical
resection is the only curative treatment, whenever possible. Nevertheless, major
pancreatectomies lead to high postoperative morbidity rate, in particular up to 30% fistula
rate. In case of parenchyma-sparing procedures, this rate is even higher, up to 40%.
One of the reasons of these high rates might be explained by the fact that pancreatic
transections are currently not performed following pancreatic segmentation. If possible,
resection following vascular segmentation would prevent necrosis of the transection,
resection following lymphatic segmentation would improve the lymph-node dissection, and
resection following pancreatic-duct segmentation would prevent leakage from pancreatic duct
stump. Nevertheless, no precise "anatomic" pancreatic segmentation currently exists.
On the other hand, the lymphatic system of the pancreas is highly complex, but the quality of
the lymphadenectomy during pancreatectomy is essential since the recurrences almost always
occur on the lymphatic transections. A better knowledge of the peri-pancreatic lymphatic
vessels is still required.
The aim of this study is to demonstrate the existence of independent pancreatic segments,
following the lymphatic drainage of the gland.
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