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01-03-2015 | 2014 SSAT Poster Presentation

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

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

Published in: Journal of Gastrointestinal Surgery | Issue 3/2015

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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Title: Perioperative and Long-Term Outcome after Standard Pancreaticoduodenectomy, Additional Portal Vein and Multivisceral Resection for Pancreatic Head Cancer
Authors: Birte Kulemann
Jens Hoeppner
Uwe Wittel
Torben Glatz
Tobias Keck
Ulrich F. Wellner
Peter Bronsert
Olivia Sick
Ulrich T. Hopt
Frank Makowiec
Hartwig Riediger
Publication date: 01-03-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 3/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-014-2725-8

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

Abstract

Introduction

Methods

Results

Conclusion

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Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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