Use of a temporary intraoperative mesentericoportal shunt for pancreatic resection for locally advanced pancreatic cancer with portal vein occlusion and portal hypertension

Bachellier, Philippe; Rosso, Edoardo; Fuchshuber, Pascal; Addeo, Pietro; David, Pierre; Oussoultzoglou, Elíe; Lucescu, Ioan

doi:10.1016/j.surg.2013.09.003

Cited by 38 publications

(21 citation statements)

References 17 publications

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“…Types of arterial resection included pancreaticoduodenectomy with the superior mesenteric artery (n = 9), celiac trunk (n = 1), common hepatic artery (n = 1), splenic artery (n = 1) and left hepatic artery (n = 1); total pancreatectomy with celiac trunk resection (n = 2), and distal splenopancreatectomy with celiac trunk resection (n = 9). In 15 LA cancer patients, a temporary mesentericoportal shunt was used intraoperatively [17]. The mean operative time was 680 ± 112 min.…”

Section: Resultsmentioning

confidence: 99%

Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy

et al. 2015

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Objective: To report the outcomes of surgical resection of borderline resectable (BL) and locally advanced (LA) ‘unresectable' pancreatic cancer after neoadjuvant chemotherapy. Methods: A review of a prospectively maintained database for pancreatic resections was undertaken to identify patients undergoing resection for BL and LA pancreatic cancer after neoadjuvant chemotherapy between January 2007 and December 2012. Clinicopathological, surgical and survival outcomes were analyzed. Results: A total of 45 patients with LA (n = 34) or BL cancer (n = 11) underwent surgery after a mean (± SD) of 7 ± 4 preoperative chemotherapy cycles. Ninety-day mortality was 6.7%, and overall morbidity was 33.3%. An R0 resection was achieved in 34 patients, and 4 patients showed a complete pathological response. Overall median postoperative survival was 17 months (21 after the start of neoadjuvant treatment). Overall and disease-free survival was 74.9 and 43.6% at 1 year and 21.2 and 10.3% at 3 years, respectively. In BL cancer patients, the 3-year survival was significantly higher compared to that of LA cancer patients (p = 0.02). Conclusions: Curative intent resection in BL and LA cancer patients after neoadjuvant chemotherapy can be achieved with reasonable mortality and morbidity and an encouraging 3-year survival. After neoadjuvant therapy, resection provides a better overall survival for BL compared to LA cancer patients.

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Section: Resultsmentioning

confidence: 99%

Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy

et al. 2015

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“…We try to reduce the length of the segment of PV/SMV resection as short as possible. There are several reports that suggest making a portal‐systematic or hepatic shunt to avoid the congestion of the portal vein and the liver failure . We usually do not place any shunt for PV/SMV.…”

Section: Methodsmentioning

confidence: 99%

Tips and tricks of surgical technique for pancreatic cancer: portal vein resection and reconstruction (with videos)

Yoshitomi

Kato

Shimizu

et al. 2014

J Hepato Biliary Pancreat

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Surgical resection is the only hope for cure in patients with pancreatic cancer. To improve the resectability and achieve better prognosis of this lethal disease, extended resection for pancreatic cancer has been applied. We have performed portal vein resection aggressively for pancreatic cancer with portal vein invasion. We also established a method of portal vein reconstruction using the left renal vein graft for tumors widely extended to the portal vein. Our data show similar survival between patients with portal vein obstruction and those without invasion. We also show that portal vein reconstruction using the left renal vein graft can be performed safely without severe liver damage. With video, we introduce our surgical technique for portal vein resection and reconstruction, especially focusing on the usage of the left renal vein graft, providing several tips for a safe and successful procedure.

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“…b) The HA can perfuse the "total liver" (Michell type 9: 1-5%): in this rare setting, it requires reconstruction of any type [direct anastomosis, by an interposed "reversed" saphenous vein graft (44,53,117) (LE 4) or reversal of the splenic artery (127) (LE 4)] to ensure vascularization of the biliary tree and the hepatico-jejunostomy following PD. HA should be reconstructed before continuing pancreatic resection to avoid any liver ischemia, particularly when an associated venous resection is needed.…”

Section: Commentsmentioning

confidence: 99%

Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019

Delpero

Sauvanet

2020

Front. Oncol.

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Use of a temporary intraoperative mesentericoportal shunt for pancreatic resection for locally advanced pancreatic cancer with portal vein occlusion and portal hypertension

Cited by 38 publications

References 17 publications

Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy

Resection of Borderline Resectable and Locally Advanced Pancreatic Adenocarcinomas after Neoadjuvant Chemotherapy

Tips and tricks of surgical technique for pancreatic cancer: portal vein resection and reconstruction (with videos)

Vascular Resection for Pancreatic Cancer: 2019 French Recommendations Based on a Literature Review From 2008 to 6-2019

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