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Clinical Trial
. 2001 Feb;129(2):158-63.
doi: 10.1067/msy.2001.110221.

Segmental resection and wedge excision of the portal or superior mesenteric vein during pancreatoduodenectomy

R C van Geenen  1 , F J ten Kate, L T de Wit, T M van Gulik, H Obertop, D J Gouma
Affiliations
Clinical Trial

Segmental resection and wedge excision of the portal or superior mesenteric vein during pancreatoduodenectomy

R C van Geenen et al. Surgery. 2001 Feb.

Abstract

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.

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