Outcome of superior mesenteric-portal vein resection during pancreatectomy for borderline ductal adenocarcinoma: results of a prospective comparative study

Abstract

Suspicion of vein infiltration should not be a contraindication to resection. Pancreatectomy can be safely performed with an acceptable morbidity and better survival trend.

The Role of Venous and Arterial Resection in Pancreatic Cancer Surgery

“…12 Data on venous resections for any type of pancreatectomy, not limited to tumors of the head, have also demonstrated similar long-term survival for those undergoing surgery with or without concomitant SMV and/or PV resection. 13,14 One study also noted an increased benefit of vascular resection for those surviving beyond 1 year. 14 Reported perioperative mortality and morbidity rates have been low and comparable with those for standard resection procedures.…”

“…13,14 One study also noted an increased benefit of vascular resection for those surviving beyond 1 year. 14 Reported perioperative mortality and morbidity rates have been low and comparable with those for standard resection procedures. [13][14][15] The literature on venous resection of tumors of the head requiring pancreaticoduodenectomy (PD) is particularly enriched 16 and covered in depth later in this report.…”

“…65 Only one recent large meta-analysis evaluating all types of pancreatectomy (PD, total pancreatectomy, and distal pancreatectomy) demonstrated that patients undergoing PV-SMV resection had increased mortality, higher rates of R1/R2 resections, and worse survival. 56 Numerous studies have found that tumor-free margins 14 46 For tumors located in the pancreatic neck involving the SMV, PV, and termination of the splenic vein, a procedure termed ''Whipple at the splenic artery'' (WATSA) has been described by Strasberg et al 69 for a series of 10 cases demonstrating no mortality. This approach requires isolation of the SMV below and the PV above the pancreas, followed by division of the splenic vein precisely where the splenic artery comes in contact with the pancreas superiorly.…”

Perioperative outcomes of pancreaticoduodenectomy: Superior mesenteric artery first approach in Rajavithi Hospital, Thailand

“…Currently, pancreatoduodenectomy (PD) and reconstruction of the portal vein (PV) or superior mesenteric vein (SMV) is being increasingly done to reach a negative margin without markedly affecting mortality or morbidity. 1,2 Nevertheless, major arterial involvement is considered a contraindication for PD. 3 During the past decades, a new modification of the standard PD has been proposed, termed "superior mesenteric artery (SMA) first approach".…”

Хірургічне Лікуваннях Хворих Із Місцеворозповсюдженими Пухлинами Підшлункової Залози

“…У зв'язку з локорегіонарним зростанням та раннім системним розповсюджен-ням аденокарциноми ПЗ локальна інвазія магістральних судин та прилеглих органів, наявність віддалених метастазів часто обмежують резектабельність пухлини [6,7]. Таким чином, комбіноване лікування з розширеними резекціями ПЗ нерідко є єдиною можливістю на їх радикальне лікування та довготривале виживання [8][9][10][11][12].…”