The role of vascular resections in the surgical treatment of pancreatic cancer

Abstract

PG. The pancreatic remnant was mobilized 2e3 cm from the splenic vein and the surrounding tissues. A 2 cm long seromuscular incision is made in the posterior wall of the stomach exposing the gastric mucosa. A submucosal tunnel 2 cm in length is created. A seromuscular continuous circular suture was placed around the gastric incision. The pancreatic remnant was then pulled with slide tension in the seromuscular tunnel into the stomach. Ideally, the pancreatic remnant should pass through a submucosal tunnel into the posterior gastric wall by 2e3 cm. The seromuscular continuous circular suture was tied to the lowest part of the pancreatic stump. Results: The overall mortality, morbidity and pancreatic leakage following PD were 4% (n = 6), 41.2% (n = 61) and 9.6% (n = 15), respectively. The mortality, morbidity and pancreatic leakage were 5.1% (n = 6), 44.8% (n = 52) and 11.2% (n = 13) in the PJ group, and 0%, 28.1% (n = 9) and 6.2% (n = 2) in the PG group (p < 0.05). Conclusions: Submucosal PG with continuous circular suture is a safer method than PJ, following PD at a significantly lower rate of pancreatic leakage, surgical morbidity and mortality. This technique is simple and reduces the risk of pancreatic leakage by removing the danger of suture injury of the pancreas.