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Published on: February 2, 2022
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[Vascular resection and reconstruction techniques in pancreatic surgery]
J Klose1, T Hackert1, M W Büchler1
1Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universität Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|December 18, 2015
Summary
Pancreatic cancer surgery requires vascular resection and reconstruction for organ perfusion. While venous resections have safe options, arterial resections carry higher risks but can achieve complete tumor removal and survival in select cases.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Vascular Surgery
Background:
- Pancreatic cancer treatment necessitates R0 resection for cure.
- Vascular infiltration poses significant challenges in pancreatic cancer surgery.
- Maintaining hepatic and small intestinal perfusion after resection is critical.
Purpose of the Study:
- To review indications and techniques for vascular resection and reconstruction in pancreatic cancer therapy.
- To discuss current literature on surgical management of pancreatic cancer with vascular involvement.
Main Methods:
- Systematic literature search of Medline, Embase, and Cochrane Library.
- Identification of studies on venous and arterial vascular resection techniques.
- Analysis of postoperative morbidity, mortality, and patient survival.
Main Results:
- Pancreatic cancer with vascular infiltration is not always unresectable.
- Venous vascular resection offers various safe technical options.
- Arterial vascular resections increase morbidity and mortality but can enable R0 resection and survival in selected patients.
Conclusions:
- Vascular resection and reconstruction are integral to curative pancreatic cancer surgery.
- Careful patient selection is crucial for arterial vascular resections.
- Achieving R0 resection through vascular reconstruction can lead to prolonged survival.
