Acta Biomedica Scientia

OUTCOMES OF EN BLOC VASCULAR RESECTION IN PANCREATIC ADENOCARCINOMA: A RETROSPECTIVE ANALYSIS OF SURGICAL RESECTION WITH VENOUS AND ARTERIAL INVOLVEMENT

Amirthalingam A.G, Prabhakar ReddyE

drpebyreddy@gmail.com

Pancreatic adenocarcinoma, Vascular resection, Surgical resection, Perioperative outcomes Prognostic factors

Preoperative and intraoperative aggressive actions can be deployed to enhance the resectability rates and outcomes that are likely to occur in the case of locally advanced pancreatic adenocarcinoma which occludes the vein. Some controversy exists on whether there should be a role of the venous and more importantly the arterial resection in the treatment of adenocarcinoma of pancreatic organ. The retrospective experience of the included patients who were enrolled in the prospective databases. Two referral centres of specialty. They are retrospective analysis of the two prospective databases of 593 consecutive pancreatic resections that have been carried out to pancreatic adenocarcinoma that had been done between January 1, 1999 and May 1, 2007. The preset study was conducted at Sri Lakshmi Narayana Institute of Medical Sciences, Pondicherry. Pancreatectomy was performed together with vascular resection in three point one percent of 593patients. Among them, isolated venous resection was respectably performed in 31 (88%) patients, artery and vein combined resection was taken in 3 (8%) patients and resection alone (the superior mesenteric artery) was taken by 2 (6%) patients. It consisted of 18 men and 18 women aged 62 years old (range, 42-82) in median age. The percentage of the patients which died and suffered complications 90 days perioperative were 0% and 35 respectively and in the number of patients which had nonvasculation pancreatic resection were 2 and 39 respectively (P =.34). The median survival of 18 months and a range of 8-42 in group of vascular resection and was found to be 19 months in nonvascular resection. The outcome of the multivariate approach of the analysis revealed that the presence of node- positive disease, tumor site (not locating at the head) and the absence of adjuvant treatment were bad prognosticators. The en bloc vascular resection, whether it involved the venous resection only, the arterial resection only or the combination of the two which was performed as an extension of the procedure of the pancreatectomy in the affected patients with adenocarcinoma did not in any form adversely influence the post-operative mortality, morbidity or/and on the overall survival of the patient. The necessity of performing a vascular resection which was preformed contingent of the situation should not be a reason to not proceed with surgical resection of the properly chosen patient