Venous Resection in Pancreatic Ductal Adenocarcinoma: Impact of Surgical Experience on Early Postoperative Courses

Abstract

Background/aim: The aim of this study was to determine the effects of surgical experience on early postoperative courses after pancreaticoduodenectomy (PD) with venous resection.

Patients and methods: From 2005 to 2014, 134 patients were analyzed, 62 and 72 patients were resected in periods 1 (2005-2009) and 2 (2010-2014) respectively; 115 and 19 patients underwent PD with venous resection in high- and low-volume center groups respectively.

Results: Of the entire cohort, mortality rate was 4%. There were no significant differences between the two periods. In the low-volume center group, the mortality rate was increased (21% vs. 2%, p<0.01) and the mean length of hospital stay was longer (25 (±27) days vs. 17 (±8) days, p=0.04). The high-volume center group was the only independent protective factor regarding death (OR=0.04, 95%CI (0.01-0.38), p<0.01) and length of hospital stay (OR<0.01, 95%CI (0.00-0.43), p=0.03).

Conclusion: Patients who present isolated venous invasion must be referred to high-volume centers for surgery.

Keywords: Pancreaticoduodenectomy; high-volume center; mortality; surgical experience; venous resection.