title: Vascular resection in pancreatic adenocarcinoma with portal or superior mesenteric vein invasion.
abstract: OBJECTIVE
  To evaluate long-term survival after the Whipple operation with superior mesenteric vein/portal vein resection (SMV/PVR) in relation to resection length.
  
  
  METHODS
  We evaluated 118 patients who underwent the Whipple operation for pancreatic adenocarcinoma at our Department of Hepatobiliary Pancreatic Surgery between 2005 and 2010. Fifty-eight of these patients were diagnosed with microscopic PV/SMV invasion by frozen-section examination and underwent SMV/PVR. In 28 patients, the length of SMV/PVR was ≤ 3 cm. In the other 30 patients, the length of SMV/PVR was > 3 cm. Clinical and survival data were analyzed.
  
  
  RESULTS
  SMV/PVR was performed successfully in 58 patients. There was a significant difference between the two groups (SMV/PVR ≤ 3 cm and SMV/PVR > 3 cm) in terms of the mean survival time (18 mo vs 11 mo) and the overall 1- and 3-year survival rates (67.9% and 14.3% vs 41.3% and 5.7%, P < 0.02). However, there was no significant difference in age (64 years vs 58 years, P = 0.06), operative time (435 min vs 477 min, P = 0.063), blood loss (300 mL vs 383 mL, P = 0.071) and transfusion volume (85.7 mL vs 166.7 mL, P = 0.084) between the two groups.
  
  
  CONCLUSIONS
  Patients who underwent the Whipple operation with SMV/PVR ≤ 3 cm had better long-term survival than those with > 3 cm resection.
authors.affiliation: Gang Pan, Kun-Lin Xie, Hong Wu, Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Pan
authors.affiliation: Gang Pan, Kun-Lin Xie, Hong Wu, Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Kun-Lin
authors.initials: KL
authors.lastname: Xie
authors.affiliation: Gang Pan, Kun-Lin Xie, Hong Wu, Department of Hepatobiliary Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wu
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality
keywords: Pancreatic adenocarcinoma; Vascular resection; Whipple operation