Regional vascular resection using catheter bypass procedure for pancreatic cancer

Abstract

Background/aims: To elucidate the indications for extended operation including main vessel resection in pancreatic cancer surgery, a clinical study was performed. The safety and clinical significance of portal vein resection in pancreatic cancer surgery have not yet been obtained in a large series.

Materials and methods: Over a period of more than 10 years, 134 of 212 (63%) patients with pancreatic carcinoma underwent resection by extensive radical surgery. Portal vein resection was performed in 104 of 134 (78%) resected cases using catheter bypass procedure. The postoperative survival was investigated and a clinicopathological study was conducted.

Results: Operative death within 30 days after operation was observed in 11 of 134 (8%) resected cases. Postoperative survival rate correlated with the grade of portal vein invasion, which was diagnosed by preoperative or intraoperative portography. Survival for more than two years after operation was seen in cases of negative invasion on the margins of the resected specimens group even when portal system vein wall invasion was observed.

Conclusion: Portal vein resection is performed safely using bypass procedure of the portal vein and is recommended to obtain a tumor-free surgical margin.