Mesenteric-Portal Vein Resection during Pancreatectomy for Pancreatic Cancer

• Main Authors: Valentina Beltrame, Mario Gruppo, Sergio Pedrazzoli, Stefano Merigliano, Davide Pastorelli, Cosimo Sperti
• Format: Article
• Language: English
• Published: Hindawi Limited 2015-01-01
• Series: Gastroenterology Research and Practice
• Online Access: http://dx.doi.org/10.1155/2015/659730
• ISSN: 1687-6121; 1687-630X

The aim of the present study was to determine the outcome of patients undergoing pancreatic resection with (VR+) or without (VR−) mesenteric-portal vein resection for pancreatic carcinoma. Between January 1998 and December 2012, 241 patients with pancreatic cancer underwent pancreatic resection: in 64 patients, surgery included venous resection for macroscopic invasion of mesenteric-portal vein axis. Morbidity and mortality did not differ between the two groups (VR+: 29% and 3%; VR−: 30% and 4.0%, resp.). Radical resection was achieved in 55/64 (78%) in the VR+ group and in 126/177 (71%) in the VR− group. Vascular invasion was histologically proven in 44 (69%) of the VR+ group. Survival curves were not statistically different between the two groups. Mean and median survival time were 26 and 15 months, respectively, in VR− versus 20 and 14 months, respectively, in VR+ group p=0.52. In the VR+ group, only histologically proven vascular invasion significantly impacted survival p=0.02, while, in the VR− group, R0 resection p=0.001 and tumor’s grading p=0.01 significantly influenced long-term survival. Vascular resection during pancreatectomy can be performed safely, with acceptable morbidity and mortality. Long-term survival was the same, with or without venous resection. Survival was worse for patients with histologically confirmed vascular infiltration.