One-Year Survival Outcomes in Patients with Pancreatic Head and Portomesenteric Veins Resection

Czech version

Authors: R. Gürlich ¹; M. Oliverius ²; K. Lipár ²; M. Varga ²; J. Špičák ³; P. Štirand ³; A. Valsamis ²; J. Novotný ⁴; F. Vyhnánek ¹
Authors‘ workplace: Chirurgická klinika 3. LF UK a FNKV, přednosta: prof. MUDr. Robert Gürlich, CSc. ¹; Klinika transplantační chirurgie IKEM, přednosta prof. MUDr. M. Adamec, CSc. ²; Klinika hepatogastroenterologie IKEM, přednosta: prof. MUDr. J. Špičák, CSc. ³; Onkologická klinika 1. LF UK Praha, přednosta: prof. MUDr. Luboš Petruželka, CSc. ⁴
Published in: Rozhl. Chir., 2009, roč. 88, č. 8, s. 417-421.
Category: Monothematic special - Original

Overview

Introduction:
Hemipancreatoduodenectomy is a standard technique for surgical management of pancreatic head carcinomas. However, so far, mesenteric and/or portal vein resections have not been commonly indicated. This original report presents one-year survival outcomes in a group of operated subjects.

Methodology:
From 7/2005 to 7/2008, 13 pancreatic resections with concomitant resection of the mesenteric or portal vein were performed in the IKEM Transplant Surgery Clinic. The study objective was to assess the perioperative complications and 30-day mortality rates, and the overall survival period.

Results:
The study group included 13 patients, 8 males and 5 females, the mean age was 66 (48 to 85) years. Concomitantly, resection of the portal vein (6x) or the superior mesenteric vein (3x), or of the both veins (4x) was performed. In 11 subjects of this patient group, the time period between the surgical procedure and the assessment was over a year. During the portomesenteric reconstruction phase, end-to-end anastomoses were performed in eight subjects, and the resected vein was replaced with the internal jugular vein in two subjects. In three subjects, the venous wall excision site was closed using a simple defect suture.

Out of the study group, 5 subjects were surviving at 12 months. Three patients exited due to their primary diagnosis and the fourth one for internal complications two months after the procedure.

Conclusion:
The authors belive that hemipancreatoduodenectomy with concomitant resection of portomesenteric veins should become a standard treatment method in indicated patients, performed in specialized centres.

Key words:
hemipancreatoduodenectomy – vein resection – pancreatic carcinoma

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