Pancreaticoduodenectomy with vascular resection

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dc.contributor.author Abdalla, Eddie
dc.contributor.author Tseng, Jennifer
dc.contributor.author Raut, Chandrajit
dc.contributor.author Lee, Jeffrey
dc.contributor.author Pisters, Peter
dc.contributor.author Vauthey, Nicolas
dc.contributor.author Gomez, Henry
dc.contributor.author Sun, Charlotte
dc.contributor.author Crane, Christopher
dc.contributor.author Wolff, Robert
dc.contributor.author Evans, Douglas
dc.date.accessioned 2015-11-11T07:31:10Z
dc.date.available 2015-11-11T07:31:10Z
dc.date.issued 2015-11-11
dc.identifier.issn 1091-255X en_US
dc.identifier.uri http://hdl.handle.net/10725/2528
dc.description.abstract Major vascular resection performed at the time of pancreaticoduodenectomy (PD) for adenocarcinoma remains controversial. We analyzed all patients who underwent vascular resection (VR) at the time of PD for any histology at a single institution between 1990 and 2002. Preoperative imaging criteria for PD included the absence of tumor extension to the celiac axis or superior mesenteric artery (SMA). Tangential or segmental resection of the superior mesenteric or portal veins was performed when the tumor could not be separated from the vein. As a separate analysis, all patients who underwent PD with VR for pancreatic adenocarcinoma were compared to all patients who underwent standard PD for pancreatic adenocarcinoma. A total of 141 patients underwent VR with PD. Superior mesenteric-portal vein resections included tangential resection with vein patch (n = 36), segmental resection with primary anastomosis (n = 35), and segmental resection with autologous interposition graft (n = 55). Hepatic arterial resections were performed in 10 patients, and resections of the anterior surface of the inferior vena cava were performed in 5 patients. PD was performed for pancreatic adenocarcinoma in 291 patients; standard PD was performed in 181 and VR in 110. Median survival was 23.4 months in the group that required VR and 26.5 months in the group that underwent standard PD (P = 0.177). A Cox proportional hazards model was constructed to analyze the effects of potential prognostic factors (VR, tumor size, T stage, N status, margin status) on survival. The need for VR had no impact on survival duration. In conclusion, properly selected patients with adenocarcinoma of the pancreatic head who require VR have a median survival of approximately 2 years, which does not differ from those who undergo standard PD and is superior to historical patients believed to have locally advanced disease treated nonoperatively. en_US
dc.language.iso en en_US
dc.title Pancreaticoduodenectomy with vascular resection en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle Margin status and survival duration en_US
dc.author.school SOM en_US
dc.author.idnumber 201100945 en_US
dc.author.woa N/A en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Gastrointestinal Surgery en_US
dc.journal.volume 8 en_US
dc.journal.issue 8 en_US
dc.article.pages 935-950 en_US
dc.keywords Pancreaticoduodenectomy en_US
dc.keywords Pancreatic cancer en_US
dc.keywords Vascular resection en_US
dc.identifier.doi http://dx.doi.org/10.1016/j.gassur.2004.09.046 en_US
dc.identifier.ctation Tseng, J. F., Raut, C. P., Lee, J. E., Pisters, P. W., Vauthey, J. N., Abdalla, E. K., ... & Evans, D. B. (2004). Pancreaticoduodenectomy with vascular resection: margin status and survival duration. Journal of Gastrointestinal Surgery, 8(8), 935-950. en_US
dc.author.email eddie.abdalla@lau.edu.lb
dc.identifier.url http://link.springer.com/article/10.1016/j.gassur.2004.09.046

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