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. 2025 Jul;27(7):910-921.
doi: 10.1016/j.hpb.2025.03.005. Epub 2025 Mar 15.

Global survey on surgeon preference and current practice for pancreatic neck and body cancer with portomesenteric venous involvement

Hiroyuki Ishida  1 , Thomas F Stoop  2 , Atsushi Oba  3 , Philippe Bachellier  4 , Daisuke Ban  5 , Itaru Endo  6 , Oskar Franklin  7 , Tsutomu Fujii  8 , Aiste Gulla  9 , Thilo Hackert  10 , Asif Halimi  11 , Satoshi Hirano  12 , Jin-Young Jang  13 , Matthew H G Katz  14 , Aya Maekawa  15 , William H Nealon  16 , Giampaolo Perri  17 , Jose M Ramia  18 , Ingmar F Rompen  19 , Sohei Satoi  20 , Richard D Schulick  21 , Shailesh V Shrikhande  22 , Allan Tsung  23 , Christopher L Wolfgang  24 , Marc G Besselink  25 , Marco Del Chiaro  26 ; Americas Hepato-Pancreato-Biliary Association; Asian-Pacific Hepato-Pancreato-Biliary Association; Scientific and Research Committee of European-African Hepato-Pancreato-Biliary Association; European Pancreatic Club; Pancreas Club; Japanese Society of Hepato-Biliary-Pancreatic Surgery; Korean Association of Hepato-Biliary-Pancreatic Surgery; International Collaborative Group on Locally Advanced Pancreatic Cancer; International Hepato-Pancreato-Biliary Association; Collaborators
Collaborators, Affiliations

Global survey on surgeon preference and current practice for pancreatic neck and body cancer with portomesenteric venous involvement

Hiroyuki Ishida et al. HPB (Oxford). 2025 Jul.

Abstract

Background: Evidence regarding the optimal surgical approach for pancreatic neck/body cancer with portomesenteric vein (PV) involvement is scarce. We aimed to clarify the current practice using an international survey.

Methods: An online survey was distributed to members of nine international associations and study groups. Surgeons who performed pancreatectomy with PV resection (PVR) in the last 12 months were asked about three clinical scenarios with different PV involvement: scenarios A (<90°; length 1 cm), B (<90°; length 3 cm), and C (90-180°; length 3 cm), with or without common hepatic artery (CHA) involvement. PVR was defined according to the ISGPS definition.

Results: Overall, 222 surgeons from 49 countries in 6 continents completed the survey. The most selected procedures were left pancreatectomy with PVR ISGPS-type 1 for scenario A (52.3 %), PVR ISGPS-type 2 for B (28.8 %), and pancreatoduodenectomy with PVR ISGPS-type 3 for C (28.4 %). In patients with CHA involvement, the most selected procedures were left pancreatectomy without arterial reconstruction for A (57.7 %) and B (50.0 %), and total pancreatectomy for C (29.7 %).

Conclusions: The survey illustrates the heterogeneity in surgical management of pancreatic neck/body cancer with PV involvement, indicating the need for prospective studies and guidelines.

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Conflict of interest statement

Conflict of interest Marco Del Chiaro received an industry grant (Haemonetics, Inc) to conduct a multicenter study and is a co-principal investigator of an international multicenter study sponsored by Boston Scientific. Richard D. Schulick is a co-inventor of a patent licensed to DynamiCure (managed by the University of Colorado). Sohei Satoi received three grants from Nihon Servier, Amino Up Co., and Boston Scientific. Atsushi Oba has been awarded a grant (Bayer Yakuhin, Ltd.) to conduct an observational study to investigate the clinical impact of EOB-MRI. No other disclosures were reported from the other authors.