[Analysis of a series of 100 mesenterico-portal vein resections during pancreatic resection].
Pancreatic resection is currently the only treatment offering the possibility of long-term survival for patients with pancreatic cancer. Mesentericoportal vein involvement used to be considered a contraindication to pancreatic resection, but recent advances in vascular surgery have gradually extended the indications of curative pancreatic resection to such cases. We report hereby our experience of 100 pancreatic resections combined with mesentericoportal vein resection for pancreatic malignancies, performed between 1989 and 2005. This is one of the largest reported series. The overall mortality rate was 4% and the morbidity rate was 39%. Among the 76 patients who had pancreatic adenocarcinoma, the 5-year survival rate in case of limited mesenterico-portal vein wall involvement (up to the adventitia) was similar to that among patients without histological involvement of the portal vein wall (35.8% and 26.7%, respectively). These results support aggressive management consisting of resection and reconstruction of the mesentericoportal veins in patients with venous involvement, provided curative R0 resection is feasible.
Jaeck
Daniel
D
Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Avenue Molière, 67098 Strasbourg, France.
Bachellier
Philippe
P
Oussoultzoglou
Elie
E
Audet
Maxime
M
Rosso
Edoardo
E
Wolf
Philippe
P
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D019917:Blood Vessel Prosthesis Implantation; D018278:Carcinoma, Neuroendocrine / Q000601:surgery*; D002423:Cause of Death; D003536:Cystadenocarcinoma / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010193:Pancreaticojejunostomy; D011169:Portal Vein / Q000601:surgery*; D011183:Postoperative Complications; D012307:Risk Factors; D013270:Stomach / Q000601:surgery