Pancreaticoduodenectomy with Major Vascular Resection and Reconstruction

Introduction: Extended pancreatic resections with the aim of complete tumor extirpation were performed by many surgeons over the last 3 decades in order to extend the resection eligibility in patients with advanced disease. Many recent publications showed that venous resections and reconstructions are increasingly performed as the technique is feasible and reliable, with a morbidity and mortality similar to pancreati-coduodenectomy without vascular reconstruction.Patient and Methods: The data of seventeen patients with borderline resectable pancreatic cancer who had divided into two groups; VR+ group (extended pancreatectomy with venous resection and reconstruction) of seven patients and VR– group (conventional surgery without venous resection and reconstruction) of ten patients were reviewed. Operative time, blood loss and transfusion, mortality and morbidity and median survival were calculated.Results: Statistical analysis showed higher mean operative time in VR+ group compared with VR– (8.78 vs. 6.55 hs), slightly higher mean blood loss (1721 vs. 1625 cc), comparable mean blood transfusion (2.71 vs. 2.7 units). Operative mortality rate was 28.5% (2/7) in the VR+ group with no mortality in VR– group was recorded. Comparable mean survival between the two groups (16.6 vs. 15.5 months).Conclusion: In our study, the vein resection group (VR+) showed significantly higher operation time, slightly higher blood loss and complication rate with higher intra-hospital mortality. However, comparable median intraoperative blood transfusion, and median hospitalization time with overall survival in vein resected group was not significantly different than patients without.