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Survival following pancreaticoduodenectomy with resection of the superior mesenteric-portal vein confluence for adenocarcinoma of the pancreatic head.
Br J Surg. 1998 May; 85(5):611-7.BJ

Abstract

BACKGROUND

The survival of patients who underwent pancreaticoduodenectomy with or without en bloc resection of the superior mesenteric-portal vein (SMPV) confluence for adenocarcinoma of the pancreatic head was compared.

METHODS

To be considered for surgery, patients were required to fulfil the following computed tomography criteria for resectability: (1) absence of extrapancreatic disease, (2) no evidence of tumour extension to the superior mesenteric artery (SMA) or coeliac axis, and (3) a patent SMPV confluence. Tumour adherence to the superior mesenteric vein (SMV) or SMPV confluence was assessed at operation and en bloc venous resection was performed when necessary to achieve complete tumour extirpation.

RESULTS

Seventy-five consecutive patients underwent pancreaticoduodenectomy, 44 without venous resection and 31 with en bloc resection of the SMPV confluence. There were no perioperative deaths in either group; late (more than 6 months) occlusion of the reconstructed SMPV confluence contributed to the death of two patients. Median survival in the 31 patients who required venous resection at the time of pancreaticoduodenectomy was 22 months, and that for the 44 control patients was 20 months (P = 0.25).

CONCLUSION

Patients with adenocarcinoma of the pancreatic head who require venous resection during pancreaticoduodenectomy for isolated tumour extension to the SMV or SMPV confluence (in the absence of tumour extension to the SMA or coeliac axis) have a duration of survival no different from that of patients who undergo standard pancreaticoduodenectomy. These data suggest that venous involvement is a function of tumour location rather than an indicator of aggressive tumour biology.

Authors+Show Affiliations

Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9635805

Citation

Leach, S D., et al. "Survival Following Pancreaticoduodenectomy With Resection of the Superior Mesenteric-portal Vein Confluence for Adenocarcinoma of the Pancreatic Head." The British Journal of Surgery, vol. 85, no. 5, 1998, pp. 611-7.
Leach SD, Lee JE, Charnsangavej C, et al. Survival following pancreaticoduodenectomy with resection of the superior mesenteric-portal vein confluence for adenocarcinoma of the pancreatic head. Br J Surg. 1998;85(5):611-7.
Leach, S. D., Lee, J. E., Charnsangavej, C., Cleary, K. R., Lowy, A. M., Fenoglio, C. J., Pisters, P. W., & Evans, D. B. (1998). Survival following pancreaticoduodenectomy with resection of the superior mesenteric-portal vein confluence for adenocarcinoma of the pancreatic head. The British Journal of Surgery, 85(5), 611-7.
Leach SD, et al. Survival Following Pancreaticoduodenectomy With Resection of the Superior Mesenteric-portal Vein Confluence for Adenocarcinoma of the Pancreatic Head. Br J Surg. 1998;85(5):611-7. PubMed PMID: 9635805.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival following pancreaticoduodenectomy with resection of the superior mesenteric-portal vein confluence for adenocarcinoma of the pancreatic head. AU - Leach,S D, AU - Lee,J E, AU - Charnsangavej,C, AU - Cleary,K R, AU - Lowy,A M, AU - Fenoglio,C J, AU - Pisters,P W, AU - Evans,D B, PY - 1998/7/4/pubmed PY - 1998/7/4/medline PY - 1998/7/4/entrez SP - 611 EP - 7 JF - The British journal of surgery JO - Br J Surg VL - 85 IS - 5 N2 - BACKGROUND: The survival of patients who underwent pancreaticoduodenectomy with or without en bloc resection of the superior mesenteric-portal vein (SMPV) confluence for adenocarcinoma of the pancreatic head was compared. METHODS: To be considered for surgery, patients were required to fulfil the following computed tomography criteria for resectability: (1) absence of extrapancreatic disease, (2) no evidence of tumour extension to the superior mesenteric artery (SMA) or coeliac axis, and (3) a patent SMPV confluence. Tumour adherence to the superior mesenteric vein (SMV) or SMPV confluence was assessed at operation and en bloc venous resection was performed when necessary to achieve complete tumour extirpation. RESULTS: Seventy-five consecutive patients underwent pancreaticoduodenectomy, 44 without venous resection and 31 with en bloc resection of the SMPV confluence. There were no perioperative deaths in either group; late (more than 6 months) occlusion of the reconstructed SMPV confluence contributed to the death of two patients. Median survival in the 31 patients who required venous resection at the time of pancreaticoduodenectomy was 22 months, and that for the 44 control patients was 20 months (P = 0.25). CONCLUSION: Patients with adenocarcinoma of the pancreatic head who require venous resection during pancreaticoduodenectomy for isolated tumour extension to the SMV or SMPV confluence (in the absence of tumour extension to the SMA or coeliac axis) have a duration of survival no different from that of patients who undergo standard pancreaticoduodenectomy. These data suggest that venous involvement is a function of tumour location rather than an indicator of aggressive tumour biology. SN - 0007-1323 UR - https://www.unboundmedicine.com/medline/citation/9635805/Survival_following_pancreaticoduodenectomy_with_resection_of_the_superior_mesenteric_portal_vein_confluence_for_adenocarcinoma_of_the_pancreatic_head_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0007-1323&date=1998&volume=85&issue=5&spage=611 DB - PRIME DP - Unbound Medicine ER -