Graft choice in pancreatectomy with vascular resection: equivalent safety in selected patients

Daniel Hoffman ¹, Amir Ashraf Ganjouei ¹, Fernanda Romero Hernandez ¹

⁰Department of Surgery, University of California, San Francisco, CA, United States.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract +

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August 24, 2024

View abstract on PubMed

Summary

Pancreatic cancer surgery often involves vascular resection and reconstruction. Unsuspected vascular involvement is common, but outcomes are good with careful patient selection and appropriate graft use.

Area Of Science

Surgical Oncology
Vascular Surgery
Gastrointestinal Surgery

Background

Pancreatic cancer is a leading cause of cancer death.
Surgical resection offers the only chance for long-term survival.
Managing vascular involvement is key to resectability.

Purpose Of The Study

To investigate vascular resection and reconstruction patterns in pancreatectomy.
To evaluate outcomes and complications of vascular management during pancreatic surgery.

Main Methods

Single-center retrospective review (2010-2022).
Included adult patients undergoing pancreatectomy with vascular involvement.
Primary endpoint: graft thrombosis within 90 days.

Main Results

147 patients analyzed; 21.8% had unsuspected vascular involvement.
68% required vascular reconstruction, 32% underwent repair.
No predictors of thrombosis found; CryoVein showed similar outcomes to autologous grafts.

Conclusions

Pancreatectomy with vascular resection is feasible with low mortality.
Unsuspected vascular involvement is frequent.
CryoVein is a safe alternative to autologous grafts when needed.

Keywords:

Pancreatectomy Pancreatic cancer Pancreatoduodenectomy Vascular reconstruction Vascular resection