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Perioperative and Long-Term Outcome after Standard Pancreaticoduodenectomy, Additional Portal Vein and Multivisceral Resection for Pancreatic Head Cancer

  • 2014 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

The value of extended resection (portal vein, multivisceral) in patients with pancreatic adenocarcinoma (PDAC) is not well defined. We analyzed the outcome after standard resection (standard pancreaticoduodenectomy (SPR)), additional portal vein (PV) and multivisceral (MV) resection in PDAC patients.

Methods

Clinicopathologic, perioperative, and survival data of patients undergoing pancreatic head resection (PHR) for PDAC 1994–2014 were reviewed from a prospective database.

Results

Three hundred fifty nine patients had PHR for PDAC: 208 (58 %) underwent SPR, 131 (36 %) additional PV, and 20 (6 %) MV. The postoperative complication rate in MV (65 %) was slightly higher than in PV (56 %) or SPR (50 %; p = 0.32). MV patients had higher in-hospital mortality (10 %) than SPR (3.8 %) and PV (1.5 %) patients (p = 0.12). Nodal status was comparable, whereas more patients in PV and MV had final R0 resection (p = 0.02). Five-year survival was 7 % after MV versus 17 % in patients without MV (p = 0.07). Multivariate survival analysis identified resection margin, nodal disease, blood transfusions, and MV are set as independent risk factors for overall survival.

Conclusion

Multivisceral pancreatic head resections for PDAC are associated with increased perioperative morbidity and mortality, without improving oncologic outcome. Portal vein resection can be performed safely to reach R0 resection and its survival benefits.

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Authors and Affiliations

  1. Department of Surgery, University of Freiburg, Hugstetter Str. 55, D-79106, Freiburg, Germany

    Birte Kulemann, Jens Hoeppner, Uwe Wittel, Torben Glatz, Tobias Keck, Ulrich F. Wellner, Olivia Sick, Ulrich T. Hopt, Frank Makowiec & Hartwig Riediger

  2. Institute of Pathology, University of Freiburg, Freiburg, Germany

    Peter Bronsert

Authors
  1. Birte Kulemann
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  2. Jens Hoeppner
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  3. Uwe Wittel
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  4. Torben Glatz
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  5. Tobias Keck
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  6. Ulrich F. Wellner
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  7. Peter Bronsert
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  8. Olivia Sick
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  9. Ulrich T. Hopt
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  10. Frank Makowiec
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  11. Hartwig Riediger
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Correspondence to Birte Kulemann.

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Kulemann, B., Hoeppner, J., Wittel, U. et al. Perioperative and Long-Term Outcome after Standard Pancreaticoduodenectomy, Additional Portal Vein and Multivisceral Resection for Pancreatic Head Cancer. J Gastrointest Surg 19, 438–444 (2015). https://doi.org/10.1007/s11605-014-2725-8

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  • DOI: https://doi.org/10.1007/s11605-014-2725-8

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