Clinical significance of combined pancreas and portal vein resection in surgery for pancreatic adenocarcinoma.
OBJECTIVE
Surgical resection remains the only potentially curative treatment for pancreatic adenocarcinoma for which the resectability and prognosis are still poor. The aim of the present study was to evaluate the efficacy of portal vein resection for pancreatic adenocarcinoma.


METHODS
Between August 1983 and December 2000, 69 patients with pancreatic ductal cell carcinoma underwent resection in our department; 22 of the 69 had combined resection of the pancreas and portal vein. When the pancreas could not be separated from the portal vein, the vein was judged to be invaded by cancer and resected.


RESULTS
The mortality rate for portal vein resection was 4.5%, which was similar to that in 47 patients with no resection of the portal vein (2.1%). Postoperative histologic analysis showed that 8 (37%) of the patients who underwent portal vein resection did not have cancer invasion to the portal vein, and 3 of them remain disease free to date. The 3-year survival rate of patients undergoing portal vein resection was 21.3%, and that of patients without portal vein resection was 20.0%.


CONCLUSIONS
Resection of the portal vein in cases of pancreatic ductal cell carcinoma has no adverse affect on long-term survival for selected patients.
Aramaki
Masanori
M
Department of Surgery I, Oita Medical University, 1-1 Idaigaoka, Hasama, Oita 879-0055, Japan.
Matsumoto
Toshifumi
T
Etoh
Tsuyoshi
T
Ishio
Tetsuya
T
Himeno
Yoshihisa
Y
Sasaki
Atsushi
A
Yada
Kazuhiro
K
Kawano
Katsunori
K
Kitano
Seigo
S
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D017063:Outcome Assessment, Health Care; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*