IS SUPERIOR MESENTERIC-PORTAL RESECTION A SAFE PROCEDURE DURING THE PANCREATICODUODENECTOMY AND DOES IT AFFECT THE SURVIVAL AND MORBIDITY RATE?
Dr. M. A. Tolga MÜFTÜOĞLU, Dr. Mehmet ODABAŞI, Dr. Ali AKTEKİN, Dr. Abdullah SAĞLAM
4. Genel Cerrahi Kliniği, Haydarpaşa Numune Eğitim ve Araştırma Hastanesi, Üsküdar/ İstanbul
The aim of this clinical prospective study is to analyze the effect of pancreaticoduodenectomy with or without superior mesenteric-portal vein resection on the survival and morbidity rates. Periampullary cancers have very low survival rates and the best treatment is still surgical approach. One of the reasons of the low resectability rates is the tumoral invasion of superior mesenteric-portal vein.
Twenty-six patients with periampullary tumors were treated in our clinic. Five patients were operated with by-pass procedure. Thirteen patients underwent pancreaticoduodenectomy alone and eight patients underwent pancreaticoduodenectomy plus vein resections. Standard pancreaticoduodenectomy for 2 patients and pylorus preserving pancreaticoduodenectomy for 19 patients were done. Our general resectability rate was 80%. The mean survial for pancreaticoduodenectomy and pancreaticoduodenectomy plus vein resection were 22 and 18 months (p=0.1), respectively. Six complete vein resections 1 partial vein resection and 1 internal jugular vein grafting were done. There was no mortality. Complications were similar in two groups.
We concluded that superior mesentericportal vein resections can be safely performed during the performance of pancreaticoduodenectomy if it is indicated.
Keywords: Mean survival rate, pancreaticoduodenectomy, superior mesenteric-portal vein.