The importance of superior mesenteric-portal vein resection for radical duodenopancreatectomy of pancreatic adenocarcinoma / 中国普通外科杂志

ABSTRACT

Objective To investigate morbidity, mortality and survival of patients with adenocarcinoma of the pancreas who underwent pancreaticoduodenectomy with en bloc portal vein resection, and to evaluate its effect on radical resection of pancreatic carcinoma. Methods Between 1999 and 2003, 32 patients with ductal adenocarcinoma of the head of the pancreas who underwent pancreaticoduodenectomy with SMPV resection were retrospectively analyzed. Patients were divided into two groups with group A(n = 12) in which the wall of portal vein was surrounded by carcinoma without true invasion,and group B(n = 20) , by tumor transmural invasion. Results The overall morbidity was 31% , there was no operative mortality, the 1,3-year survival rate was 59% and 22% respectively. The mean survival time of patients with microscopically positive margin was 5. 6 months as compared with 20 months with microscopically negative margin. There was no difference in tumor size, margin positivity, nodal positivity, and 1,3-year survival rate between the two groups. Conclusions Pancreaticoduodenectomy combined with SMPV resection can be performed safely, without increasing the morbidity and mortality. SMPV resection should be performed only when a margin-negative resection is expected. SMPV invasion is not associated with histologic parameters suggesting a poor prognosis.