Results of a pancreatectomy with a limited venous resection for pancreatic cancer

Abstract

A pancreatectomy combined with a resection of the portal or superior mesenteric vein for cancer with venous involvement not exceeding 2 cm is indicated in order to extend the potential benefits of a curative resection.

Extended Pancreaticoduodenectomy with Vascular Resection for Pancreatic Cancer: A Systematic Review

“…The most common techniques of reconstruction after vascular resection include end-end anastomosis and graft reconstruction (using either an autologous vein graft or synthetic graft). The surgical procedure resulted in estimated blood loss that was reported in 18 of 28 studies (64%) [15][16][17][18][19][20][22][23][24][26][27][28][29]32,33,37,40 ranging between 700 and 3,083 mL with a median of 1,494 mL (Table 2).…”

“…[13][14][15][16][17][18][19][20][21][22]24,[26][27][28][29]31,32,[34][35][36][37] Among which, vein thrombosis was a reported contraindication to surgery in 13 of 21 studies (62%), and arterial involvement was a reported contraindication to surgery in 15 of 21 studies (71%) ( Table 1).…”

“…14,16,18,22,23,25,[27][28][29][30][31][32][33]36,37,40 In these centers, 10 of 16 studies (63%) 14,16,18,22,25,27,28,31,36,40 reported a com- 14,16,18,22,25,28,31,36,40 The median survival of patients undergoing extended pancreaticoduodenectomy with vascular resection was 15 months (range, 9 to 23 months).…”

“…Twenty-one of 28 studies (75%) [13][14][15][16][17][18][19][22][23][24][25][27][28][29][31][32][33][34][36][37][38][39][40] reported margin status after extended pancreaticoduodenectomy with vascular resection. Microscopically clear margin (R0) rates ranged from 14% to 100% with a median of 75%.…”

“…One thousand, one hundred thirty-six patients (78%) underwent pancreaticoduodenectomy. In undertaking vascular resection, 23 of 28 studies (82%) [13][14][15][17][18][19][20][21][22][23][24][25][26][27][29][30][31][32][34][35][36]38,39 examined the resected vessel histologically. The histopathological analysis of the resected vessel indentified true neoplastic invasion in between 21% and 100% of cases with a median of 63%.…”