, Volume 16, Issue 4, pp 789-791,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 24 Jan 2009

Pancreaticoduodenectomy and Vascular Resection: Persistent Controversy and Current Recommendations

This is an excerpt from the content

In this issue of the Journal, Giovanni and colleagues analyze 12 recent manuscripts which reported the outcome of patients with pancreatic cancer who required portal vein (PV) or superior mesenteric vein (SMV) resection at the time of pancreaticoduodenectomy (PD).1 They conclude that venous resection can be safely performed and should be considered in appropriately selected patients. Fortner first popularized vascular resection at the time of PD in 1973 when he proposed the use of “regional pancreatectomy.”2 However, this concept has remained controversial for the following reasons:

  1. Most physicians do not understand the difference between the historical experience with regional pancreatectomy and isolated tumor resection of the SMV, PV or superior mesenteric–portal vein (SMPV) confluence performed as part of a gross complete resection of the primary tumor. Vascular resection at the time of PD was initially performed in an attempt to improve survival duration by performing an en bloc r ...

An erratum to this article can be found at http://dx.doi.org/10.1245/s10434-009-0417-5