C. Shibata et al., Pancreatectomy combined with superior mesenteric-portal vein resection foradenocarcinoma in pancreas, WORLD J SUR, 25(8), 2001, pp. 1002-1005
The aims of this study were to investigate morbidity, mortality, and surviv
al of patients with ductal adenocarcinoma of the pancreas who underwent pan
createctomy without (group 1) or with (group 2) en bloc portal vein resecti
on and to study the degree of carcinoma invasion of the portal vein in grou
p 2. The medical records of 46 and 28 patients in groups I and 2, respectiv
ely, were reviewed. In addition, the degree of invasion of the wall of the
portal vein was categorized histologically into three types: type 1, transm
ural invasion involving the intima; type II, invasion of the wall of the ve
in without intimal involvement; and type III, compression of the wall of th
e vein by surrounding carcinoma without true invasion. The morbidity and mo
rtality in group 1 (26% and 4%) were not different from those in group 2 (3
2% and 4%). Similarly, there was no difference in survival between the two
groups. Survival tended to vary directly with the depth of invasion of the
wall of the portal vein: type 1 6.8 +/- 1.9 months; type II 15.3 +/- 6.4 mo
nths; type III 20.6 +/- 13.0 months. These findings suggest that en bloc re
section of the pancreas and the portal vein does not increase mortality and
morbidity after pancreatectomy; survival after en bloc resection was simil
ar to that of patients not requiring portal vein resection. Combined resect
ion of the pancreas with the portal vein could be an option in the treatmen
t of pancreatic cancer with direct invasion of the portal vein.