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- W2734808863 abstract "Objective: Pancreaticoduodenectomy is the gold standard treatment for malignancies involving the pancreatic head, modifyng outcome, but most of the cases are not resectable at the time of diagnoses. Resectability can be increased by including vascular structures, although that will increase R0 resections, increased complication rates and a worse outcome has been published. We aim here to report the outcome of patients undergoing pancreatodoudenectomy with vascular resection (VR+PD), compared to the group of patients resected without vascular resection (VR−PD) in a single HPB surgical center. Methods: Retrospective review from 1/2008 to 12/2015. Demographics, tumor characteristics, including histologically proven vascular invasion, post operative complications stratified by Dindo–Clavien, overall patient and recurrence free survival, were analyzed using SPSS® v.20, p<0.05 was considered significant. Results: One hundred nineteen pancreatic resections were performed, 76 were PD, and 65 (85.5%) PD for malignancies. From them, 18 required VR+, and all have histologically proved vascular involvement. No significant differences between groups were found in terms of age, sex, pathology and transfusion requirement. Significant differences are shown in Table 1. With a mean follow up of 39.5 months (SD: 28.2 months), the long term patient and disease free survivals were no different between groups (Figures 1 and 2). Conclusion: VR+PD can be performed in order to extend the indication in patients with pancreatic malignancies. Patients will benefit from achieving increased R0 resections, with reduced complication rate in our series, VR+PD did not affect overall patient or disease free survival, therefore VR+PD should not longer be considered a contraindication for surgery.Table 1Significant differences.VR+PD (N=18)VR−PD (N=47)PSurgical length (Hs)8,570.03Re-operation rate (%)0110.002Dindo Clavien >3 (%)0190.0001PTE (%)0110002Length of Stay (days)9.515.20034RO resections (%)50780.006 Open table in a new tab Figure 2Disease free survival.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
- W2734808863 created "2017-07-21" @default.
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- W2734808863 date "2017-04-01" @default.
- W2734808863 modified "2023-10-14" @default.
- W2734808863 title "Pancreatoduodenectomy for pancreatic malignancies: the impact of performing venous resections" @default.
- W2734808863 doi "https://doi.org/10.1016/j.hpb.2017.02.373" @default.
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