scholarly journals Portal vein resection and reconstruction with artificial blood vessels is safe and feasible for pancreatic ductal adenocarcinoma patients with portal vein involvement: Chinese center experience

Oncotarget ◽  
2017 ◽  
Vol 8 (44) ◽  
pp. 77883-77896 ◽  
Author(s):  
Zhi-Bo Xie ◽  
Ji-Chun Gu ◽  
Yi-Fan Zhang ◽  
Lie Yao ◽  
Chen Jin ◽  
...  
Keyword(s):  
Portal Vein ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Blood Vessels ◽  
Ductal Adenocarcinoma ◽  
Portal Vein Resection ◽  
Artificial Blood ◽  
Artificial Blood Vessels ◽  
Vein Resection

P-P13 Long-term outcome after portal vein resection during pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a propensity score matched analysis

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
James Russell ◽  
Claire Stevens ◽  
Rahul Bhome ◽  
Dimitrios Karavias ◽  
Ali Arshad ◽  
...  
Keyword(s):  
Propensity Score ◽  
Portal Vein ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Perineural Invasion ◽  
Nodal Metastasis ◽  
Ductal Adenocarcinoma ◽  
Safe Procedure ◽  
Portal Vein Resection ◽  
Vein Resection ◽  
The Impact

Abstract Background Portal vein resection (PVR) with pancreaticoduodenectomy (PD) is often performed to achieve clear margins for patients with vascular involvement in pancreatic ductal adenocarcinoma (PDAC). However, there is evidence to suggest that patients undergoing PVR often have more advanced cancers, therefore the impact of PVR on survival and recurrence remains unclear. The aim of this study is to assess overall (OS) and recurrence free (RFS) survival in patients who underwent PVR during PD, with particular attention to margin positivity. Methods A retrospective analysis was performed on 638 patients who underwent PD during a 12-year period. Exclusion criteria included PD for non-PDAC tumours, neoadjuvant chemotherapy or intra-operative radiotherapy. 374 patients were included in the study (90 PVR and 284 non-PVR). Patient characteristics and histopathological factors associated with OS and RFS were then evaluated using univariate and multivariate Cox regression analyses. 270 patients (90 PVR and 180 non-PVR), were matched by propensity score based on perineural invasion, pT and pN staging. The Kaplan-Meier method was used to calculate survival and log-rank tests. Results Resection margin positivity was associated with shorter OS and RFS (p < 0.0001), and the superior mesenteric vein (SMV) margin was the most significant risk factor for survival on competing risks analysis. Absent adjuvant chemotherapy, nodal metastasis and margin positivity were independent risk factors for OS and RFS on multivariate analysis. PVR was associated with higher intra-operative blood loss (p = 0.009), but was not associated with increased length of stay, complications or readmissions. PVR patients had increased pT staging, nodal metastasis and perineural invasion, however, there was no difference in OS (p = 0.551) or RFS (p = 0.256) between PVR and non-PVR after propensity matching. Conclusions Positive resection margins are associated with shorter survival times, and the SMV margin is the most significant prognostic indicator for overall survival and recurrence compared to other margins. PVR is a relatively safe procedure, however, it does not achieve the intended survival benefits of complete margin clearance. The impact on survival for margin positivity, particularly the SMV margin, and nodal metastasis should be considered when making decisions with regards to vein resection and adjuvant treatments.

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

2014 ◽  
Vol 399 (5) ◽  
pp. 659-665 ◽  
Author(s):  
Federico Selvaggi ◽  
Giuseppe Mascetta ◽  
Despoina Daskalaki ◽  
Marco dal Molin ◽  
Roberto Salvia ◽  
...  
Keyword(s):  
Portal Vein ◽  
Comparative Study ◽  
Ductal Adenocarcinoma ◽  
Portal Vein Resection ◽  
Prospective Comparative Study ◽  
Vein Resection

scholarly journals Extended Venous Resections for Borderline Resectable Pancreatic Head Adenocarcinoma—A Retrospective Studies of Nine Cases

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 978
Author(s):  
Nicolae Bacalbasa ◽  
Irina Balescu ◽  
Mihai Dimitriu ◽  
Cristian Balalau ◽  
Florentina Furtunescu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Portal Vein ◽  
Radical Surgery ◽  
Portal Vein Resection ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Venous Resection ◽  
Graft Thrombosis ◽  
Borderline Resectable Pancreatic Cancer ◽  
Vein Resection

Background: pancreatic cancer is one of the most lethal malignancies and a leading cause of cancer-related death worldwide. The only chance to improve the long-term outcomes of patients with pancreatic cancer is surgery with radical intent. Methods: in the present paper, we aim to describe a case series of 9 patients submitted to radical surgery for borderline resectable pancreatic cancer. Results: in all cases, negative resection margins were achieved. The types of venous resection consisted of tangential portal vein resection in four cases, circumferential portal vein resection with direct reanastomosis in one case and circumferential resection with graft placement in another four cases; postoperatively, one patient developed a vascular surgery-related complication consisting of graft thrombosis and thus necessitated prolonged anticoagulant therapy. Conclusions: extended venous resections can be a safe and efficient way to maximize the benefits of radical surgery in locally advanced, borderline resectable pancreatic cancer.

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