Document Detail

Segmental resection and wedge excision of the portal or superior mesenteric vein during pancreatoduodenectomy.
MedLine Citation:
PMID:  11174708     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Resection of the portal/superior mesenteric vein (PV/SMV) during pancreatoduodenectomy (PD) is disputed. Although morbidity and mortality are acceptable, survival is limited after PV/SMV resection. In this study, we evaluate the effect of PV/SMV resection. METHODS: Between 1992 and 1998, there were 215 consecutive patients who underwent PD for malignant disease. Thirty-four patients underwent a PV/SMV resection. Resection was only performed when minimal venous ingrowth was found perioperatively. Surgical techniques, perioperative parameters, and survival were analyzed. RESULTS: The percentage of PV/SMV resections was 16%. Extensive (segment) resections were performed in 6 patients. The median blood loss was 1.8 L and resection margins were microscopically tumor free in 41% of the patients. The median hospital stay was 15 days, and mortality was 0%. Median survival after PV/SMV resection for pancreatic adenocarcinoma was 14 months. CONCLUSIONS: Limited PV/SMV resection for perioperatively encountered minimal venous ingrowth during PD can be performed safely without increased morbidity and mortality but also results in a high frequency of tumor-positive resection margins.
R C van Geenen; F J ten Kate; L T de Wit; T M van Gulik; H Obertop; D J Gouma
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Surgery     Volume:  129     ISSN:  0039-6060     ISO Abbreviation:  Surgery     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-03-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0417347     Medline TA:  Surgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  158-63     Citation Subset:  AIM; IM    
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Adenocarcinoma / pathology,  surgery*
Bile Ducts*
Mesenteric Veins / pathology,  surgery*
Middle Aged
Pancreatic Ducts*
Pancreatic Neoplasms / pathology,  surgery*
Pancreaticoduodenectomy* / methods,  mortality
Portal Vein / surgery*
Prospective Studies
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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