Related Experiment Video
Updated: Jan 17, 2026
Application of End-to-end Anastomosis in Robotic Central Pancreatectomy
Published on: June 2, 2018
Short Term Safety and Long Term Patency of Arterial Reconstruction in Pancreatic Surgery
Juha Virtanen1, Ellinoora Aro1, Tiina E Lehtimäki2
1Department of Vascular Surgery, Abdominal Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Objective:
This retrospective, single centre, registry based study aimed to analyse the outcome of patients who underwent pancreatic surgery with or without arterial reconstruction at Helsinki University Hospital.
Methods:
Distal pancreatectomies (DPs), pancreatoduodenectomies (PDs), and total pancreatectomies (TPs) performed between 2005 and 2023 were identified from the hospital database and grouped according to vessel involvement: no vascular resection (NvR); portal vein and or superior mesenteric vein resection (VR); arterial resection (AR); and concomitant arterial and venous resection (V+AR). Baseline characteristics, histopathological data, post-operative outcomes, and patency of arterial reconstructions were collected and analysed. Long term survival was assessed for patients with pancreatic ductal adenocarcinoma (PDAC).
Results:
A total of 1 620 patients who underwent DP, PD, or TP during the study period were included. The number undergoing NvR was 1 244 (76.8%), VR 316 (19.5%), isolated AR 25 (1.5%), and V+AR 35 (2.2%). Post-operative pancreatic fistula was less frequent in the VR and V+AR groups compared with the NvR and AR groups. No statistically significant difference was observed in the incidence of other complications. The 30 day mortality rate was 17 (1.4%) in the NvR group, two (0.6%) in the VR group, zero in the AR group, and two (6%) in the V+AR group (p = .037). The median overall survival for PDAC patients with AR (with or without VR) was 1.31 years (95% confidence interval 0.78 - 1.83 years), and the median one and two year overall survival rates were 52.6%, and 31.6%, respectively.
Conclusion:
Arterial resection and reconstruction alone did not increase peri-operative mortality, but combining arterial and venous reconstruction did. The long term outcomes of PDAC patients with arterial resection were worse than those of patients without arterial resection. However, the dismal nature of the disease may justify an aggressive surgical approach in selected cases.
