Arterial reseotion in pancreatic cancer surgery: a single-center experience

Pancreaticoduodenal resection (PDR) with vascular reconstruction is performed in approximately 20 % of pancreatic cancer patients. The superior mesenteric vein resection and reconstruction has become a standard routine surgery, whereas arterial resection during pancreatic surgery is still an issue of controversial debate. The purpose of the study was to evaluate short-and long-term outcomes of PDR with reconstruction of various arteries. Material and Methods. Outcomes of 89 PDRs and pancreaticoduodenectomies performed in patients with stage II-IV periampullary carcinoma were assessed. The average age of the patients was 63.1 ± 8.2. There were 18 (20.2 %) PDRs with vascular reconstruction, of them 7 (7.8 %) were arterial resections. Results. in patients who underwent artery resection (n=7), complications were observed in 5 (71.4 %) cases. Out of 71 patients who underwent PDR without arterial and/or venous resection, 29 (40.8 %) had complications (p=0.229). The postoperative mortality rates were 1 (14.3 %) and 3 (4.2 %), respectively (p=0.319). The median disease-free survival was 5.0 months (95 % Ci 2.4-7.6 months) in the arterial resection group and 12.3 months (95 % Ci 9.2-15.4 months) in the standard surgery group (log-rank test, p=0,011). The median overall survival was 8.0 months (95 % Ci 3.7-12.3 months) in the in the arterial resection group and 21.8 months (95 % Ci 15.9-27.7 months) in the standard surgery group (log-rank test, p=0.011). Conclusion. The disease-free and overall survival rates were significantly worse in the arterial resection group than in the standard surgery group. This is most likely due to a small sample of patients. Further studies are needed to analyze the immediate and long-term treatment outcomes of PDR with arterial resection for pancreatic cancer.