Combined pancreatoduodenectomy and vascular reconstruction in the treatment of pancreatic head malignant tumors / 中国普通外科杂志

ABSTRACT

Objective To evaluate surgical indications and method for regional pancreatoduodenectomy combined with blood vessel reconstruction. Methods Forty-four patients underwent pancreatoduodenectomy combined with superior mesenteric vein and portal vein(smv-pv) resection and reconstruction between April 1994 and March 2001.Among them superior mesenteric artery (SMA) and hepatic artery (HA) were reconstructed in 4 and 2 cases, respectively. Partial resection of the anterior wall of the inferior vena cava was performed in one case for tumor invasion. Results The overall mortality was 7.1%,with no complications. The resected endothelium or margins of the blood vessel and pancreas were microscopically tumor free in all cases. Histological specimen examinations demonstrated adenocarcinoma of pancreas head in 43 cases, neuroendocrine adenocarcinoma was diagnosed in one case. Patients were followed-up from 3～87 months with 2 cases lost after PV/SMV for pancreatoduodectomy. Six patients have survived more than 5 yearsand 21 cases more than 3 years. Conclusion Regional pancreatoduodenectomy combined with reconstructionof blood vessel could increase tumor resection rate in properly selected patients and could be performed safely without increased morbidity and mortality.