Home Current issue Ahead of print Search About us Editorial board Archives Submit article Instructions Subscribe Contacts Login 
Year : 2017  |  Volume : 36  |  Issue : 4  |  Page : 352-359

Portal and mesenteric vein resection during pancreaticoduodenectomy and total pancreatectomy

1 Department of Hepatopancreatobiliary and Liver Transplantation Surgery, National Liver Institute, Menoufia University, Menoufia, Egypt
2 Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA
3 Department of Organ Regulatory Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan

Correspondence Address:
John A Stauffer
Division of General Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, Florida 32224
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ejs.ejs_48_17

Rights and Permissions

Background Portal vein invasion by a malignant pancreatic mass is currently not a contraindication to pancreatic resection with acceptable oncologic outcomes. Aim The aim of this paper was to identify the perioperative morbidity and long-term outcomes of venous resection (VR) during pancreaticoduodenectomy (PD) and total pancreatectomy (TP) operations. Materials and methods We carried out a retrospective study of patients undergoing PD or TP between March 1995 and December 2014 at Mayo Clinic in Jacksonville, Florida, using data collected from an institutional review board-approved prospective database. Preoperative, operative, and postoperative clinicopathological data were collected and analyzed. Results Out of 601 patients who underwent PD and TP in this study, 104 (17.3%) underwent VR. The types of VR and reconstruction were as follows: type I (lateral venorrhaphy) in 49 (47.1%) patients, type II (patch graft) in 10 (9.6%) patients, type III (primary anastomosis) in 27 (26%) patients, and type IV (interposition venous graft) in 16 (15.4%) patients. Two (1.9%) patients underwent no portomesenteric reconstruction. The 90-day major postoperative complications and mortality in patients with VR were 44.2 and 7.7%, respectively, versus 29.2 and 4.4%, respectively, in patients with standard resection. The 1-year, 3-year, 5-year, and 7-year survival rates in VR with periampullary adenocarcinoma (PAAC) were 55.1, 27, 21.9, and 15.4%, respectively, whereas in patients with PAAC without VR, the survival rates were 78.4, 45.6, 34.6, and 30.9%, respectively (P<0.01). Conclusion VR and reconstruction with PD can be performed safely with acceptable perioperative morbidity and long-term survival rates to achieve complete removal of the tumor.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded92    
    Comments [Add]    

Recommend this journal