Long-Term Patency Rates of Portal Vein/Superior Mesenteric Vein Reconstruction after Pancreatic Resection for Pancreatic Tumors: Single-Center Experience

Miroslav Tomas ^1,2, Peter Dubovan ^1,2, Jana Pavlendova ¹

⁰Department of Surgical Oncology, National Cancer Institute Bratislava, Klenova 1, 833 10 Bratislava, Slovakia.

Life (basel, Switzerland) +

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September 28, 2024

View abstract on PubMed

Summary

Pancreatic surgery often requires portal vein resection. This study found a high 90.2% patency rate for venous reconstruction at one year, indicating good long-term outcomes for patients undergoing pancreatic cancer surgery.

Area Of Science

Surgical Oncology
Vascular Surgery
Gastroenterology

Background

Achieving R0 resection in pancreatic ductal adenocarcinoma necessitates portal/superior mesenteric vein resection.
Optimal reconstruction techniques for these resected veins remain undefined, impacting patient outcomes.

Purpose Of The Study

To evaluate the long-term patency of portal/superior mesenteric vein reconstructions after pancreatic resection.
To identify predictors of postoperative venous thrombosis or stenosis following pancreatic surgery.

Main Methods

Retrospective cohort analysis of 53 patients undergoing pancreatic resection with venous resection.
Vascular reconstruction methods included primary closure, end-to-end anastomosis, and interposition grafts.
Computed tomographic imaging assessed vein patency at 3, 6, 9, and 12 months post-surgery.

Main Results

90.2% of patients demonstrated fully patent venous reconstructions at the 1-year follow-up.
No significant perioperative or postoperative factors were associated with increased reconstruction thrombosis risk.
Reconstruction types: 26.4% primary closure, 22.7% end-to-end anastomosis, 50.9% interposition graft.

Conclusions

High long-term patency rates (90.2% at 1 year) support current venous reconstruction practices in pancreatic surgery.
Further randomized controlled trials are needed to establish the optimal venous reconstruction method.

Keywords:

pancreatic cancer pancreatic resection reconstruction thrombosis venous resection