Results of application of the PTFE-conduits in the reconstruction of the main veins of the abdominal cavity mesenteric-portal system in locally advanced pancreatic cancer

Aim: study of immediate and long-term results of the surgical treatment of the locally advanced pancreatic cancer with tumor invasion of the main veins of the abdominal cavity. Material and methods. Pancreaticoduodenectomy with resection and plasty of the main veins of the abdominal cavity were performed 315 patients. 143 patients underwent for prosthetics of the main veins at their reconstruction of different vascular prosthesis. Patients have been divided into three groups. Group I (basic) — PTFE-conduits have been used in the reconstruction of the main veins (82 patients). Group II — FLL-conduits have been used in the reconstruction of the main veins (36 patients). Group III — autovenous conduits have been used in the reconstruction of the main veins (25 patients). Comparison of the duration of operation and its reconstruction stage, the quantity of blood loss, frequency of venous thrombosis in the early postoperative period and long-term patency of the reconstructed veins traced ultrasonic method in a period of 6 months, 1, 2, and 3 years after surgery have been carried. The morbidity, the frequency of the infectious complications, the hospital mortality, the mean postoperative hospital stay, median of survival have been studied after surgery. Results. Application of the PTFE-conduits resulted for decrease of the duration of the reconstruction stage of the operation, as well as the duration of the surgery and the amount of intraoperative blood loss. Decrease of the morbidity, of the postoperative hospital stay and the mortality have been noted in the I group of patients compared to groups II and III patients. Thrombosis of the prosthesis after reconstruction of the veins that led for fatal outcome has been marked in 2 patients (5.5%) in group II of the patients. The long-term patency of vascular PTFE-conduits and reconstructed veins in group 1 has been 100% in all period's observations in the postoperative period. Conclusion. PTFE-conduits are universal plastic material. Application of the PTFE-conduits for the reconstruction of the main veins of the mesenteric-portal system can reduce the duration of the reconstruction vascular stage and the operation as a whole. Applications of the PTFE-conduits reduce the morbidity, the frequency of infectious complications, postoperative hospital-stay, hospital mortality, as well as improved performance patency of the reconstructed vessels.