Efficacy of venous reconstruction in patients with adenocarcinoma of the pancreatic head.
Pancreaticoduodenectomy is often avoided in patients with portal or superior mesenteric venous involvement due to the perception that venous resection is complex, morbid, and carries a poor long-term survival. Our recent experience using state-of-the-art imaging and strict resection criteria show that venous reconstruction increases operative time, transfusion requirements, intensive care unit stay, and total hospital length of stay, but has no significant impact on operative morbidity rates, mortality rates, or the incidence of positive histologic margins. Kalpan-Meier life table analysis shows similar survival curves when compared to a contemporary cohort of patients who do not undergo venous reconstruction.
Howard
Thomas J
TJ
Pancreas Research Group and the Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. tjhoward@iupui.edu
Villanustre
Nicholas
N
Moore
Seth A
SA
DeWitt
John
J
LeBlanc
Julia
J
Maglinte
Dean
D
McHenry
Lee
L
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011169:Portal Vein / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*