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Resection of portal and/or superior mesenteric vein and reconstruction by using allogeneic vein for pT3 pancreatic cancer
Author(s) -
Zhang Xingmao,
Fan Hua,
Kou Jiantao,
Zhang Xinxue,
Li Ping,
Dai Yang,
He Qiang
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13299
Subject(s) - medicine , superior mesenteric vein , pancreaticoduodenectomy , surgery , pancreatic cancer , vein , mesenteric vein , pancreatic fistula , stage (stratigraphy) , portal vein , cancer , pancreas , resection , radiology , paleontology , biology
Background and Aim There is still controversy on the outcomes of portal vein (PV) and/or superior mesenteric vein (SMV) resection in pancreatic cancer, and there are few reports about pancreaticoduodenectomy (PD) with PV/SMV resection and reconstruction by using allogeneic vein. This study is to explore the outcomes of PD with PV/SMV resection and reconstruction by using allogeneic vein for pT3 pancreatic cancer with venous invasion. Methods Clinicopathological data of patients underwent PD with en bloc resection of PV/SMV and reconstruction by using internal iliac from August 20, 2013 to July 25, 2015 were collected and the data of patients with pT3 stage pancreatic head cancer with PV/SMV invasion were analyzed. The short ‐ and long ‐ term outcomes were presented. Results Thirty patients met the criteria of this study. PV resection and reconstruction were performed for 12 patients, SMV for 9 patients, and PV + SMV for 9 patients, respectively. The median operation time was 460 min, and the median intraoperative blood loss was 450 mL. R0 resection rate was 93.3%, total incidence of complications was 23.3%, and incidence of pancreatic fistula was 10%. The 1 ‐ year and 2 ‐ year overall survival rates were 68.6% and 39.2%, 1 ‐ year and 2 ‐ year disease free survival rates were 44.8% and 17.1%. Conclusions PD with en bloc resection of PV/SMV and reconstruction by using allogeneic vein was safe and feasible for patients with pT3 stage pancreatic head cancer with PV/SMV invasion. A large ‐ scale research with longer follow ‐ up time is required to draw a significant conclusion.