本研究介绍了 15 年来单个机构扩大胰腺切除术的演变和结果。对 2015 年至 2022 年（B 期）机构数据库进行了回顾性分析。根据国际胰腺外科研究组的定义，接受扩大胰腺切除术的患者也被纳入其中。将围手术期和生存结果与 2007-2015 年（A 期）的数据进行比较。使用回归分析来确定影响术后和长期生存结果的因素。B 期共有 197 名患者（16.1%）接受了扩大切除，而 A 期有 63 名患者（9.2%）接受了扩大切除。边缘可切除的比例较高（5 (18.5%) 对比 51 例 (47.7%)，P = 0.011) 和局部晚期肿瘤 (1 例 (3.7%) 对比 24 例 (22.4%)，P < 0.001）在 B 期被切除，并更频繁地使用新辅助治疗 (6 (22.2%) 对比 79 名 (73.8%)，P < 0.001）。围手术期死亡率（4 例（6.0%）与 12 例（6.1%），P = 0.81）和发病率（23 例（36.5%）与 83 例（42.1%），P = 0.57）具有可比性。两个时期胰腺腺癌患者的总生存期相似（17.5（95% c.i. 6.77 至 28.22）个月与 18.3（95% c.i. 7.91 至 28.68）个月，P = 0.958）。可切除的淋巴结阳性肿瘤在 B 期的无病生存期 (DFS) 较长（5.81（95% c.i. 1.73 至 9.89）个月与 14.03（95% c.i. 5.7 至 22.35）个月，P = 0.018）。 胰腺切除术日益复杂与早期相比，围手术期结果一致，无病生存期 (DFS) 有所改善。通过逐步提高手术复杂性、多模式治疗和明智的患者选择，可以切除晚期胰腺肿瘤。© 作者 2024。由牛津大学出版社代表 BJS 基金会有限公司出版。

The evolution and outcomes of extended pancreatectomies at a single institute over 15 years are presented in this study.A retrospective analysis of the institutional database was performed from 2015 to 2022 (period B). Patients undergoing extended pancreatic resections, as defined by the International Study Group for Pancreatic Surgery, were included. Perioperative and survival outcomes were compared with data from 2007-2015 (period A). Regression analyses were used to identify factors affecting postoperative and long-term survival outcomes.A total of 197 (16.1%) patients underwent an extended resection in period B compared to 63 (9.2%) in period A. Higher proportions of borderline resectable (5 (18.5%) versus 51 (47.7%), P = 0.011) and locally advanced tumours (1 (3.7%) versus 24 (22.4%), P < 0.001) were resected in period B with more frequent use of neoadjuvant therapy (6 (22.2%) versus 79 (73.8%), P < 0.001). Perioperative mortality (4 (6.0%) versus 12 (6.1%), P = 0.81) and morbidity (23 (36.5%) versus 83 (42.1%), P = 0.57) rates were comparable. The overall survival for patients with pancreatic adenocarcinoma was similar in both periods (17.5 (95% c.i. 6.77 to 28.22) versus 18.3 (95% c.i. 7.91 to 28.68) months, P = 0.958). Resectable, node-positive tumours had a longer disease-free survival (DFS) in period B (5.81 (95% c.i. 1.73 to 9.89) versus 14.03 (95% c.i. 5.7 to 22.35) months, P = 0.018).Increasingly complex pancreatic resections were performed with consistent perioperative outcomes and improved DFS compared to the earlier period. A graduated approach to escalating surgical complexity, multimodality treatment, and judicious patient selection enables the resection of advanced pancreatic tumours.© The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.