进行远端胰腺切除同时联合切除腹腔动脉干（DP-CAR）手术后的围手术期和肿瘤学效果具有重要意义。DP-CAR可用于选择性患者群体，以切除位于腹腔动脉干或肝总动脉位置的局部进展性胰腺癌，通过保存胃十二指肠动脉的逆向血流至肝脏和胃来实现手术治疗。我们分析了在一家强调胰腺外科手术的三级医院，于2003年5月至2022年4月期间接受DP-CAR手术的连续患者，这是其中一项最大的单中心研究。共有71名患者接受了DP-CAR手术，其中31名（44％）做了血管切除，42名（59％）进行了多脏器切除。40名患者（56％）实现了无切缘病变（R0）切除。整个研究患者队列的90天死亡率为8.4％。在经过16个病例后，后续55名患者的90天死亡率降至3.6％。进行延长手术，如同时进行多脏器切除（MVR）以及带或不带静脉切除（VR / -）等操作，会导致更高的主要暴发发生率（Clavien-Dindo ≥ IIIB；标准DP-CAR：19％；DP-CAR + MVR / - VR：36％）和更高的 90天死亡率（标准DP-CAR：0％；DP-CAR + MVR / - VR：11％）。DP-CAR是一种安全而有效的手术，但需要经验。通常情况下，手术切除必须通过MVR和VR等方法来延长，以实现肿瘤切除并获得良好的肿瘤学效果。然而，这种扩大切除的方法会导致术后并发症和死亡率增加。版权所有©2023 Wolters Kluwer Health，Inc。保留所有权利。

To determine perioperative and oncologic outcomes after distal pancreatectomy with en-bloc resection of the celiac axis (DP-CAR).DP-CAR can be used in a selective group of patients to resect locally advanced pancreatic cancer involving the celiac axis or common hepatic artery without arterial reconstruction by preserving retrograde blood flow via the gastroduodenal artery to the liver and stomach.We analyzed all consecutive patients who had undergone DP-CAR between May 2003 and April 2022 at a tertiary hospital specialized in pancreatic surgery and present one of the largest single-center studies.A total of 71 patients underwent DP-CAR. Additional venous resection (VR) of the mesenterico-portal axis was performed in 31 patients (44%) and multivisceral resection (MVR) in 42 patients (59%). Margin-free (R0) resection was achieved in 40 patients (56%). The overall 90-day mortality rate was 8.4% for the entire patient cohort. After a cumulated experience of 16 cases, the 90-day mortality dropped to 3.6% in the following 55 patients. Extended procedures with (+) additional MVR with or without (+/-) VR resulted in higher major morbidity (Clavien-Dindo ≥IIIB; standard DP-CAR: 19%; DP-CAR + MVR +/- VR: 36%) and higher 90-day mortality (standard DP-CAR: 0%; DP-CAR + MVR +/- VR: 11%). Median overall survival after DP-CAR was 28 months.DP-CAR is a safe and effective procedure but requires experience. Frequently, surgical resection has to be extended with MVR and VR to accomplish tumor resection which resulted in promising oncologic outcomes. However, extended resections were associated with increased morbidity and mortality.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.