title: Mesenterico-portal vein resection in patients with pancreatico-duodenal cancer is safe and may increase survival.
abstract: BACKGROUND
  Pancreatic cancer is one of the most serious gastrointestinal cancers, and in the US and Europe it is a leading cause of cancer-related mortality. Radical surgery is the only option available for long-term survival. The aim of this study was to describe the surgical technique and the results of portal vein/superior mesenteric vein resection in patients with pancreatic cancer.
  
  
  METHODS
  Between 1 April 2009 and 1 April 2013, 354 patients underwent resection for pancreatic malignancy. A total of 47 portal vein/superior mesenteric vein resections were performed in 22 men and 25 women.
  
  
  RESULTS
  A total of 44 patients (93.7%) had ductal adenocarcinomas. In all, 39 patients (83%) had T3 tumours, and 38 patients (80.9%) had involvement of lymph nodes. Furthermore, 29 patients (62%) had a pancreaticoduodenectomy, 15 patients (32%) a total pancreatectomy and three patients (6%) had a distal pancreatectomy. Six patients (17%) were reconstructed with interposition grafts, and vessels (83%) were reconstructed with an end-to-end anastomosis in the remaining 39 patients. Surgical morbidity was 29.8%, and 19.1% had non-surgical complications. The perioperative mortality (30 days) was 0%. The median survival was 25.2 months (confidence interval: 19-31.4).
  
  
  CONCLUSIONS
  Resection of the portal vein/superior mesenteric vein is a safe procedure. It is not associated with an increased perioperative morbidity and mortality. This latter finding is in accordance with the findings in other high-volume centres. The median survival was far better than expected, especially since our material included a considerable number of patients with lymph node metastases.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not relevant.
authors.affiliation: Kirurgisk Afdeling CTx, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark. storkholm@dadlnet.dk.
authors.forename: Jan Henrik
authors.initials: JH
authors.lastname: Storkholm
authors.forename: Carsten Palnæs
authors.initials: CP
authors.lastname: Hansen
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000601:surgery*; D004379:Duodenal Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome; D058017:Vascular Grafting