Factors influencing outcome in patients undergoing portal vein resection for adenocarcinoma of the pancreas

Banz, Vanessa; Croagh, Daniel; Coldham, C.; Tanière, Philippe; Buckels, J. A. C.; Isaac, John; Mayer, D.; Muiesan, Paolo; Bramhall, S.; Mirza, Darius F.

doi:10.1016/j.ejso.2011.08.134

Cited by 49 publications

(45 citation statements)

References 29 publications

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“…In contrast, most single-center experiences in the literature report that VR during pancreatectomy does not increase postoperative complication rates. [12][13][14][15]17,[27][28][29][30] This higher rate of postoperative complications did not translate into an increased length of hospital stay; overall, we found no significant difference in mortality between patients with and without VR, which is in agreement with most of the previous literature. 12,14,15,17,[28][29][30][31] Only 1 previous study, in which no difference in overall in-hospital mortality was found, reported higher 30-day mortality among patients who underwent concomitant VR.…”

Section: Commentsupporting

confidence: 82%

“…12,14,15,17,[28][29][30][31] Only 1 previous study, in which no difference in overall in-hospital mortality was found, reported higher 30-day mortality among patients who underwent concomitant VR. 27 A recent systematic review and meta-analysis, focused only on arterial resections, also found increased mortality rates among patients who underwent VR compared with pancreatectomy alone. 32 Acknowledging that case-mix differences between these studies and ours may exist, our study is substantially larger than any previous report in the literature.…”

Section: Commentmentioning

confidence: 99%

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Concomitant Vascular Reconstruction During Pancreatectomy for Malignant Disease

Worni¹,

Castleberry²,

Clary³

et al. 2013

JAMA Surg

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Objective: To assess trends in the frequency of concomitant vascular reconstructions (VRs) from 2000 through 2009 among patients who underwent pancreatectomy, as well as to compare the short-term outcomes between patients who underwent pancreatic resection with and without VR.Design: Single-center series have been conducted to evaluate the short-term and long-term outcomes of VR during pancreatic resection. However, its effectiveness from a population-based perspective is still unknown. Unadjusted, multivariable, and propensity score-adjusted generalized linear models were performed. Patients who underwent pancreatic resection with VR were at a higher risk for intraoperative (propensity score-adjusted odds ratio, 1.94; P=.001) and postoperative (propensity score-adjusted odds ratio, 1.36; P=.008) complications, while the mortality and median length of hospital stay were similar to those of patients without VR. Among the 25% of hospitals with the highest surgical volume, patients who underwent pancreatic surgery with VR had significantly higher rates of postoperative complications and mortality than patients without VR. Conclusions:The frequency of VR during pancreatic surgery is increasing in the United States. In contrast with most single-center analyses, this population-based study demonstrated that patients who underwent VR during pancreatic surgery had higher rates of adverse postoperative outcomes than their counterparts who underwent pancreatic resection only. Prospective studies incorporating long-term outcomes are warranted to further define which patients benefit from VR.

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Section: Commentsupporting

confidence: 82%

Section: Commentmentioning

confidence: 99%

Concomitant Vascular Reconstruction During Pancreatectomy for Malignant Disease

Worni¹,

Castleberry²,

Clary³

et al. 2013

JAMA Surg

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“…In other research, postoperative morbidity was similar for patients with and without PVR (13.7%) vs. PD alone (5.1%). Overall survival was similar in both groups (median PD alone 14.8 months vs. 14.5 months PD+PVR) (20).…”

Section: Scope Of Current Opinionsmentioning

confidence: 80%

Portal Vein Resection During Pancreatectomy for Pancreatic Head Adenocarcinoma. Scope of Current Opinions and own Experiences

Łaski¹,

Hać²,

Śledziński³

2014

Polish Journal of Surgery

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“…More lately, pancreatectomy with portal vein resection and reconstruction has began to gather momentum as studies demonstrated acceptable morbidity and long term survival rates comparable to standard pancreaticoduodenectomy (PD) [4][5][6] . In recent years, the morbidity and mortality rates between standard PD and pancreatico-duedenectomy with vascular resection have been similar [4,5,7,8] . Isolated venous involvement is no longer a contraindication to PD when performed by experienced surgeons at high volume centers as part of a multidisciplinary approach to localized pancreatic cancer [9] arterial resection, however, has remained highly controversial.…”

Section: Commentary On Hot Topicsmentioning

confidence: 99%

Is there a role for arterial reconstruction in surgery for pancreatic cancer?

Ravikumar

Holroyd²,

Fusai³

2013

WJGS

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Surgery remains the only potentially curative treatment for patients with pancreatic cancer. Locally advanced pancreatic cancer with vascular involvement remains a surgical challenge because high perioperative risk and the uncertainty of a survival benefit. Whilst portal vein resection has started to gather momentum because the perioperative morbidity and long term survival is comparable to standard pancreatectomy, there isn't yet a consensus on arterial resections. There have been various reports and case series of arterial resections in pancreatic cancer, with mixed survival results. Mollberg et al have appraised the heterogeneous published literature available on arterial resection in pancreatic cancer in an attempt to compare this to standard pancreatectomy. In this article, we discuss the results of this systematic review and meta-analysis, and the limitations associated with analysing results from heterogenous data. We have outlined the important features in surgery for pancreatic cancer and specifically to arterial resections, and compared arterial resections to the published literature on venous resections.

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Factors influencing outcome in patients undergoing portal vein resection for adenocarcinoma of the pancreas

Cited by 49 publications

References 29 publications

Concomitant Vascular Reconstruction During Pancreatectomy for Malignant Disease

Concomitant Vascular Reconstruction During Pancreatectomy for Malignant Disease

Portal Vein Resection During Pancreatectomy for Pancreatic Head Adenocarcinoma. Scope of Current Opinions and own Experiences

Is there a role for arterial reconstruction in surgery for pancreatic cancer?

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