Vascular resection and reconstruction in pancreatic tumours

ABSTRACT

Option for borderline resectable pancreatic cancer is pancreaticoduodenectomy [PD] with vascular resection and reconstruction. We would like to share our experience of vascular reconstruction. First patient was a 51-year male with pancreatic head carcinoma, involving posterior wall of portal vein [PV] and replacing right hepatic artery [RHA]. Along with PD, he underwent PV and RHA resection and reconstruction. Second case was a 33-year female who had distal pancreatic cyst and PV-splenic vein junction involved by tumor. Distal pancreatectomy+splenectomy and PV primary resection-reconstruction was done. Third case was a 72-year male with pancreatic neck adenocarcinoma involving PV-SMV junction. Subtotal pancreatecomy+splenectomy was done along with PV-reconstruction via splenic vein patch graft. Fourth case was a 77-year male with cystic pancreatic head mass involving PV. PD with resection and reconstruction of portal vein was done. Fifth case was a 35-year female with peri-ampullary tumor replacing RHA, coursing through the pancreatic parenchyma. So RHA was resected and reconstructed in an end-to-end fashion. Vascular resection-reconstruction can be done in borderline pancreatic cancer patients, and a considerable survival benefit can be achieved