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Updated: Dec 9, 2025

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Defining Benchmark Outcomes for Pancreatoduodenectomy With Portomesenteric Venous Resection.

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  • 1Department of HPB Surgery and Liver Transplant, Royal Free Hospital NHS Foundation Trust, London, UK.

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Summary

This study established benchmark outcomes for pancreatoduodenectomy with portomesenteric venous resection (PD with PVR) in high-volume centers. These benchmarks aid in evaluating surgical performance for this complex procedure.

Area of Science:

  • Gastroenterology and Hepatology
  • Surgical Oncology
  • Vascular Surgery

Background:

  • Pancreatoduodenectomy with portomesenteric venous resection (PD with PVR) is standard for advanced pancreatic cancer involving the portomesenteric veins.
  • Lack of established outcome benchmarks hinders comparative analysis of PD with and without PVR.

Purpose of the Study:

  • To establish clinically relevant outcome benchmark values for pancreatoduodenectomy (PD) with portomesenteric venous resection (PVR).
  • To define performance standards for high-volume centers managing patients requiring PD with PVR.

Main Methods:

  • Multicenter analysis of 1462 patients undergoing PD with PVR across 23 high-volume centers (2009-2018).
  • Nineteen outcome benchmarks established using the 75th percentile of median outcomes in a low-risk cohort (N=840).

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Main Results:

  • Benchmark cutoffs include: pancreatic fistula rate ≤14%, in-hospital mortality ≤4%, major complications (≥Grade 3) ≤36%, and 5-year survival for pancreatic ductal adenocarcinoma ≥9%.
  • Patients undergoing PD with PVR demonstrated comparatively inferior outcomes in surgical performance, morbidity, and mortality.

Conclusions:

  • Novel benchmark cutoffs provide objective measures for assessing surgical performance, morbidity, mortality, and oncological outcomes in PD with PVR.
  • These benchmarks are crucial for evaluating and improving care in high-risk patients undergoing vascular resection for pancreatic cancer.