Conclusions
Pancreaticoduodenectomy with en bloc SMPV resection may be safely performed, with rates of morbidity and mortality that are similar to those of standard pancreaticoduodenectomy. Thin-cut dynamic contrast-enhanced CT is the staging modality of choice, with selective supplementation by visceral angiography. In carefully selected patients, resection of the SMPV confluence may provide for a negative retroperitoneal margin, thus allowing patients traditionally deemed unresectable on the basis of venous involvement a median survival equivalent to those in whom standard pancreaticoduodenectomy is performed. Vascular resection for localized pancreatic cancer represents an aggressive approach to local tumor control, and is ideally combined with other aggressive local-regional therapies, including preoperative or postoperative chemoradiation and (where available) intraoperative radiotherapy. Pancreaticoduodenectomy with vascular resection also requires a high degree of institutional expertise, and is optimally under taken in high-volume centers combining accurate preoperative imaging, high-volume surgical experience, and specialized postoperative care.
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Scoggins, C.R., Meszoely, I.M., Leach, S.D., Pearson, A.S. (2002). Vascular Resection and Reconstruction for Localized Pancreatic Cancer. In: Evans, D.B., Pisters, P.W.T., Abbruzzese, J.L. (eds) Pancreatic Cancer. M. D. Anderson Solid Tumor Oncology Series. Springer, New York, NY. https://doi.org/10.1007/0-387-21600-6_13
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DOI: https://doi.org/10.1007/0-387-21600-6_13
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