Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion

Kwon, Jae Woo; Shin, Sang Hyun; Yoo, Do Guen; Hong, Sarang; Lee, Jong Woo; Youn, Woo Young; Hwang, Ki Won; Lee, Seung-Jae; Park, Guisuk; Park, Yejong; Lee, Woo Hyung; Song, Ki Byung; Lee, Jae Hoon; Hwang, Dae Wook; Kim, Song Cheol

doi:10.1097/md.0000000000022115

Cited by 11 publications

(21 citation statements)

References 40 publications

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“…Recently, an increasing number of major peripancreatic arterial resections for locally advanced PC, as defined by the NCCN criteria (Version 1.2020, 11/26/19), especially after NAC, are being reported [14] , [20] , [21] , [22] , [23] . Among them, CAR has gained the most interest [1] , [2] , [10] , [13] , [15] , [18] , [24] , although, it is still rarely performed, even in well-established pancreatic centers, where the annual number of CARs varies between 0.4 and 3.8 [1] , [2] , [13] , [16] .…”

Section: Discussionmentioning

confidence: 99%

Aorta to proper hepatic artery bypass with total pancreatectomy and celiac axis resection (TP-CAR) in a patient with locally advanced pancreas adenocarcinoma

Tsiotos

Ballian

Milas

et al. 2022

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Aorta to proper hepatic artery bypass with total pancreatectomy and celiac axis resection (TP-CAR) in a patient with locally advanced pancreas adenocarcinoma

Tsiotos

Ballian

Milas

et al. 2022

International Journal of Surgery Case Reports

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“…In 2020, Kwon et al [ 63 ] published a study conducted on 109 PDAC patients undergoing pancreatectomy with AR between 2000 and 2017. Among 109 patients, 38 underwent surgery after neoadjuvant chemotherapy, and 71 underwent upfront surgery.…”

Section: Arterial Resectionsmentioning

confidence: 99%

“…The authors concluded that pancreatectomy with AR can be an acceptable procedure in terms of postoperative morbidity and mortality in highly selected patients. Additionally, the survival benefit was noted in patients who were undergoing neoadjuvant chemotherapy compared with patients undergoing upfront surgery [ 63 ].…”

Section: Arterial Resectionsmentioning

confidence: 99%

Vascular Resection in Pancreatectomy—Is It Safe and Useful for Patients with Advanced Pancreatic Cancer?

Jabłońska

Król

Mrowiec

2022

Cancers

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Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease with poor prognosis and increased incidence. Surgical resection R0 remains the most important treatment to prolong survival in PDAC patients. In borderline and locally advanced cancer, vascular resection and reconstruction during pancreatectomy enables achieving R0 resection. This study is a comprehensive review of the literature regarding the role of venous and arterial resection with vascular reconstruction in the treatment of pancreatic cancer. The literature review is focused on the use of venous and arterial resection with immediate vascular reconstruction in pancreaticoduodenectomy. Different types of venous and arterial resections are widely described. Different methods of vascular reconstructions, from primary vessel closure, through end-to-end vascular anastomosis, to interposition grafts with use autologous veins (internal jugular vein, saphenous vein, superficial femoral vein, external or internal iliac veins, inferior mesenteric vein, and left renal vein or gonadal vein), autologous substitute grafts constructed from various parts of parietal peritoneum including falciform ligament, cryopreserved and synthetic allografts. The most attention was given to the most common venous reconstructions, such as end-to-end anastomosis and interposition graft with the use of an autologous vein. Moreover, we presented mortality and morbidity rates as well as vascular patency and survival following pancreatectomy combined with vascular resection reported in cited articles.

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“…With neoadjuvant FOLFIRINOX ( 4 – 6 ) combined arterial or major venous resection ( 7 , 8 ) applied to borderline resectable pancreatic cancer (BRPC) and locally advanced pancreatic cancer (LAPC), the overall radical resection rate of pancreatic cancer has been improved to some extent. With the rapid spread of standardized surgical procedures for pancreatic cancer and the optimization of perioperative patient management, increasing evidence supports pancreatic surgery combined with arteriovenous resection and reconstruction for LAPC patients with encouraging short-term and long-term prognoses ( 9 – 11 ).…”

Section: Introductionmentioning

confidence: 99%

A single-center initial experience on laparoscopic pancreatic operation combined with hepatic arterial resection and reconstruction

Wang

Lei

et al. 2023

Front. Surg.

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ObjectiveThis study aims to summarize our single-center initial experience in laparoscopic pancreatic operation (LPO) combined with hepatic arterial resection and reconstruction, as well as to demonstrate the feasibility, safety, and key surgical procedure for LPO.MethodsWe retrospectively analyzed 7 patients who had undergone LPO combined with hepatic arterial resection and reconstruction in our center from January 2021 to December 2022. The clinical data of these 7 patients were collected and analyzed.ResultsIn our case series, two patients underwent passive arterial resection and reconstruction due to iatrogenic arterial injury, and five patients underwent forward arterial resection and reconstruction due to arterial invasion. The arterial anastomosis was successful in 5 cases, including 2 cases of end-to-end in situ and 3 cases of arterial transposition, and the vascular reconstruction time was 38.28 ± 15.32 min. There were two conversions to laparotomy. The postoperative recovery of all patients was uneventful, with one liver abscess (Segment 4) and no Clavien III–IV complications. We also share valuable technical feedback and experience gained from the initial practice.ConclusionsBased on the surgeon's proficiency in open arterial resection and reconstruction and laparoscopic technique. This study demonstrated the feasibility of total laparoscopic hepatic arterial resection and reconstruction in properly selected cases of arterial involvement or iatrogenic arterial injury. Our initial experience provides valuable information for laparoscopic pancreas surgery with arterial resection and reconstruction.

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Arterial resection during pancreatectomy for pancreatic ductal adenocarcinoma with arterial invasion

Abstract: Supplemental Digital Content is available in the text

Cited by 11 publications

References 40 publications

Aorta to proper hepatic artery bypass with total pancreatectomy and celiac axis resection (TP-CAR) in a patient with locally advanced pancreas adenocarcinoma

Aorta to proper hepatic artery bypass with total pancreatectomy and celiac axis resection (TP-CAR) in a patient with locally advanced pancreas adenocarcinoma

Vascular Resection in Pancreatectomy—Is It Safe and Useful for Patients with Advanced Pancreatic Cancer?

A single-center initial experience on laparoscopic pancreatic operation combined with hepatic arterial resection and reconstruction

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