20.500.12556/DiRROS-18889 Pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head with venous resection Background. Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels. Methods. Review of database at University Clinical Centre Maribor identified 133 patients (average age 65.4 +/- 8.6 years, 69 female patients) who underwent pancreatoduodenectomy between January 2006 and August 2014. Clinical data, operative results, pathological findings and postoperative outcomes were collected prospectively and analyzed. Current literature and our experience in pancreatectomies with en bloc vascular resection and reconstruction of portal vein are reviewed. Results. Twenty-two patients out of 133 (16.5 %) had portal vein-superior mesenteric vein resection and portal vein reconstruction (PVR) during pancreaticoduodenectomy. In fourteen patients portal vein was reconstructed without the use of synthetic vascular graft. In these series two types of venous reconstruction were performed. When tumour involvement was limited to the superior mesenteric vein (SPV) or portal vein (PV) such that the splenic vein could be preserved, and vessels could be approximated without tension a primary end-to-end anastomosis was performed. When tumour involved the SMV-splenic vein confluence, splenic vein ligation was necessary. In the remaining eight procedures interposition graft was needed. Dacron grafts with 10 mm diameter were used. There was no infection after dacron grafting. One patient had portal vein thrombosis after surgery: it was thrombosis after primary reconstruction. There were no thromboses in patients with synthetic graft interposition. There were no significant differences in postoperative morbidity, mortality or grades of complication between groups of patients with or without a PVR. Median survival time in months was in a group with vein resection 16.13 months and in a group without vein resection 15.17 months. Five year survival in the group without vein resection was 19.5%. Comparison of survival curves showed equal hazard rates with log-rank p = 0.090. Conclusions. Survival of patients with pancreatic cancer who undergo an R0 resection with reconstruction was comparable to those who have a standard pancreaticoduodenectomy with no added mortality or morbidity. Synthetic graft appeared to be an effective and safe option as an interposition graft for portomesenteric venous reconstruction after pancreaticoduodenectomy. pankreatoduodenektomija trebušna slinavka rak (medicina) vena resekcija kirurgija preživetje true false true Association of Radiology and Oncology Ljubljana Angleški jezik Slovenski jezik by Authors Neznano 2024-05-09 13:31:25 2024-05-09 13:31:25 2024-05-10 03:36:24 0000-00-00 00:00:00 2016 0 0 Soavtorji: Stojan Potrc, Nina Kobilica, Arpad Ivanecz; str. 321-328, VI no. 3 Vol. 50 Sep. 2016 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 2016-09-01 616.37-006-089 1318-2099 10.1515/raon-2015-0017 5390911 http://ojs.szd.si/index.php/ro/article/view/2302 1 abb393c1-0df7-11ef-9c9e-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=25863 RAZ_Flis_Vojko_2016.pdf RAZ_Flis_Vojko_2016.pdf 1 7E32A96BAE1330A98F55DFD369F9D9A8 2be5d7caa42a36f346a5a993bec8bc211160f9f32a24c0a8f891a372b010d9ac cfd3e800-0df7-11ef-9c9e-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=25864 Onkološki inštitut Ljubljana 0 0 0