Should the Portal Vein Be Routinely Resected During Pancreaticoduodenectomy For Adenocarcinoma?

• DOI: 10.1097/sla.0b013e318269d23c
• Publication Date: 2012-09-11T08:06:51Z
• Authors: Olivier Turrini; Jacques Ewald; Louise Barbier; Djamel Mokart; Jean Louis Blache; Jean Robert Delpero
• Keywords: Superior mesenteric vein; Perineural invasion; Resection margin; Lymphadenectomy

In Brief Introduction: pancreatic adenocarcinoma (PA), a margin negative resection (R0) is critical for long-term survival. Background: Although pancreaticoduodenectomy (PD) with en-bloc portal vein/superior mesenteric vein (PV/SMV) used in patients venous involvement by tumor, its utility no unknown. This study examines survival who had PD PV/SMV resection. Methods: From 2000 to 2010, 34 resectable PA on preoperative staging. Fifteen (44%) histological and 19 (56%) (–PV/SMV group). We matched 1:1 the –PV/SMV group (n = 19) contemporaneous standard (control group) age, tumor stage, size, lymph node invasion, ratio, perineural margins status, carbohydrate antigen 19-9 (CA 19-9) levels. Results: No differences were noted between control morbidity, mortality, reoperation rate, or length of hospital stay. Median (42 months vs. 22 months, P 0.02) overall 3-year (60% 31%, 0.03) significantly longer compared group. Conclusions: Patients than without experienced