Pancreatoduodenectomy en bloc with portal and superior mesenteric artery resection--a case report and literature review.
BACKGROUND
Pancreatic cancer is one of the most lethal malignancies and is associated with a very poor overall survival. However, it seems that the only curative option remains an aggressive surgical approach capable of obtaining a radical resection. Unfortunately, this desiderate is even harder to be obtained when it comes to pancreatic tumors with vascular invasion.


METHODS
We present the case of a 65-year-old patient who was diagnosed with a cephalopancreatic tumor invading both the portal vein and the superior mesenteric artery.


RESULTS
Whipple procedure was performed with portal and superior mesenteric artery resection; the continuity of the portal vein was established by an end-to-end anastomosis, while the superior mesenteric artery was re-implanted in the infra-renal aorta.


CONCLUSIONS
Due to improvements of surgical techniques and postoperative management, the postoperative morbidity and early mortality significantly decreased and enabled the surgeon to perform ultra-radical surgery with better outcome.
Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
Vladislav
V
Brasoveanu
Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
Claudiu
C
Anghel
Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
Ion
I
Barbu
Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
Mihai
M
Pautov
Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
Mihnea I
MI
Ionescu
Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
Manish
M
Motthor
"Ponderas Hospital", Bucharest, Romania.
Irina
I
Balescu
Department of General Surgery and Liver Transplantation "Dan Setlacec", Fundeni Clinical Institute, Bucharest, Romania.
Simona
S
Dima
"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania nicolae_bacalbasa@yahoo.ro.
Nicolae
N
Bacalbasa
D000368:Aged; D006801:Humans; D017538:Mesenteric Artery, Superior / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D016896:Treatment Outcome
Vascular invasion; pancreatic cancer; pancreatoduodenectomy; portal vein resection; re-implantation; superior mesenteric artery resection