Vascular Resections with PancreaticoduoDenectomy for Pancreatic and Non-pancreatic Periampullary Cancers

While outcomes following pancreaticoduodenectomy (PD) have generally improved, the results of PD with vascular resection (PD-VR) remain inconsistent. The objective of this study was to evaluate short- and long-term outcomes in patients who underwent standard PD (S-PD) or PD-VR. This single-center retrospective cohort study included patients who underwent PD between 2011 and 2023. Histopathological and surgical outcomes were compared between S-PD (n = 173) and PD-VR (n = 30). We looked at short-term morbidity, mortality, and 5-year overall survival (OS). The median age was 60 years (range 50-66 years), with ampullary adenocarcinoma being the most common tumor type in 79 patients (38.9%). Type 3 and type 4 venous resections were performed in 21/30(70%) patients and 6/30(20%) patients underwent arterial resection. The PD-VR group had longer operative times and higher intra-operative blood loss (P < 0.05). The in-hospital mortality was 1/173 (0.6%) and 1/30 (3.3%) in the S-PD and PD-VR groups (P = 0.274). There was no significant difference in the rates of positive microscopic margins (P > 0.05). For pancreatic cancer, the 5-year OS for S-PD and PD-VR were 20% and 9%, respectively (P = 0.039), while for non-pancreatic periampullary cancers, the 5-year OS for S-PD and PD-VR was 39% and 31%, respectively (P = 0.215). Vascular resections with PD can be performed with comparable short-term and acceptable long-term outcomes.