Skip to main content
SpringerLink
Log in
Book cover

Pancreatic Cancer pp 161–169Cite as

Vascular Resection and Reconstruction for Localized Pancreatic Cancer

  • Chapter

  • 239 Accesses

Part of the book series: M. D. Anderson Solid Tumor Oncology Series ((MDA))

Conclusions

Pancreaticoduodenectomy with en bloc SMPV resection may be safely performed, with rates of morbidity and mortality that are similar to those of standard pancreaticoduodenectomy. Thin-cut dynamic contrast-enhanced CT is the staging modality of choice, with selective supplementation by visceral angiography. In carefully selected patients, resection of the SMPV confluence may provide for a negative retroperitoneal margin, thus allowing patients traditionally deemed unresectable on the basis of venous involvement a median survival equivalent to those in whom standard pancreaticoduodenectomy is performed. Vascular resection for localized pancreatic cancer represents an aggressive approach to local tumor control, and is ideally combined with other aggressive local-regional therapies, including preoperative or postoperative chemoradiation and (where available) intraoperative radiotherapy. Pancreaticoduodenectomy with vascular resection also requires a high degree of institutional expertise, and is optimally under taken in high-volume centers combining accurate preoperative imaging, high-volume surgical experience, and specialized postoperative care.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Cancer facts and figures. American Cancer Society, 1998

    Google Scholar 

  2. Evans DB, Abbruzzese JL, Rich TA. Cancer of the pancreas. In: De Vita VT, Hellman S, Rosenberg SA, eds. Cancer: Principles and Practice of Oncology. 5th ed. Philadelphia, Pa: JB Lippincott;1997:1054–1087.

    Google Scholar 

  3. Klempnauer J, Ridder GJ, Bektas H, et al. Surgery for exocrine pancreatic cancer-who are the 5-and 10-year survivors? Oncology. 1995;52:353–359.

    CAS  PubMed  Google Scholar 

  4. Nitecki SS, Sarr MG, Colby TV, et al. Long-term survival after resection for ductal adenocarcinoma of the pancreas. Is it really improving? Ann Surg. 1995;221:59–66.

    CAS  PubMed  Google Scholar 

  5. Trede M, Schwall G, Saeger H. Survival after pancreaticoduodenectomy. 118 consecutive resections without an operative mortality. Ann Surg. 1990;211:447–458.

    CAS  PubMed  Google Scholar 

  6. Willett CG, Lewandrowski K, Warshaw AL, et al. Resection margins in carcinoma of the head of the pancreas. Implications for radiation therapy. Ann Surg. 1993;217:144–148.

    CAS  PubMed  Google Scholar 

  7. Yeo CJ, Cameron JL, Lillemoe KD, et al. Pancreaticoduodenectomy for cancer of the head of the pancreas: 201 patients. Ann Surg. 1995;221:721–733.

    CAS  PubMed  Google Scholar 

  8. The Gastrointestinal Tumor Study Group. A multiinstitutional comparative trial of radiation therapy alone and in combination with 5-fluorouracil for locally unresectable pancreatic carcinoma. Ann Surg. 1979;189:205–208.

    Google Scholar 

  9. Furhman GM, Leach SD, Staley CA, et al. Rationale for en bloc vein resection in the treatment of pancreatic adenocarcinoma adherent to the superior mesenteric-portal vein confluence. Ann Surg. 1996;223:154–162.

    Google Scholar 

  10. Leach SD, Lee JE, Charnsangavej C, et al. Survival following pancreaticoduodenectomy with resection of the superior mesenteric-portal vein confluence for adenocarcinoma of the pancreatic head. Br J Surg. 1998;85:611–617.

    Article  CAS  PubMed  Google Scholar 

  11. Bold RJ, Charnsangavej C, Cleary KR, et al. Major vascular resection as part of pancreaticoduodenectomy for cancer: radiologic, intraoperative, and pathologic analysis. J Gastrointest Surg. 1999;3(3):233–243.

    CAS  PubMed  Google Scholar 

  12. Furhman G, Charnsangavej C, Abbruzzese JL, et al. Thin-section contrast enhanced computed tomography accurately predicts resectability of malignant pancreatic neoplasms. Am J Surg. 1994;167:104–111.

    Google Scholar 

  13. Cusack JC, Furhman GM, Lee JE, et al. Management of unsuspected tumor invasion of the superior mesenteric-portal venous confluence at the time of pancreaticoduodenectomy. Am J Surg. 1994;168:352–354.

    PubMed  Google Scholar 

  14. Evans DB, Lee JE, Leach SD, et al. Vascular resection and intraoperative radiation therapy during pancreaticoduodenectomy: rationale and technique. Adv Surg. 1996;29:235–262.

    CAS  PubMed  Google Scholar 

  15. Sugiyama M, Hagi H, Atomi Y, et al. Diagnosis of portal venous invasion by pancreatobiliary carcinoma: value of endoscopic ultrasonography. Abdom Imaging. 1997;22:434–438.

    Article  CAS  PubMed  Google Scholar 

  16. Brugge WR, Lee MJ, Kelsey PB, et al. The use of EUS to diagnose malignant portal venous system invasion by pancreatic cancer. Gastrointest Endosc. 1996;43(6):561–567.

    Article  CAS  PubMed  Google Scholar 

  17. Midwinter MJ, Beveridge CJ, Wilsdon JB, et al. Correlation between spiral computed tomography, endoscopic ultrasonography and findings at operation in pancreatic and ampullary tumours. Br J Surg. 1999;86:189–193.

    CAS  PubMed  Google Scholar 

  18. Robinson EK, Lee JE, Lowy AM, et al. Reoperative pancreaticoduodenectomy for periampullary carcinoma. Am J Surg. 1996;172:432–438.

    Article  CAS  PubMed  Google Scholar 

  19. Tyler DS, Evans DB. Reoperative pancreaticoduodenectomy. Ann Surg. 1994;219(2):211–221.

    CAS  PubMed  Google Scholar 

  20. Biehl TR, Traverso LW, Hauptmann E, et al. Preoperative visceral angiography alters intraoperative strategy during the Whipple procedure. Am J Surg. 1993;165:607–612.

    CAS  PubMed  Google Scholar 

  21. Thompson NW, Eckhauser FE, Talpos G, et al. Pancreaticoduodenectomy and celiac occlusive disease. Ann Surg. 1981;193(4):399–406.

    CAS  PubMed  Google Scholar 

  22. Ishikawa O, Ohigashi H, Imaoka S, et al. Preoperative indication for extended pancreatectomy for locally advanced pancreas cancer involving the portal vein. Ann Surg. 1992;215(3):231–236.

    CAS  PubMed  Google Scholar 

  23. Ishikawa O, Ohigashi H, Sasaki Y, et al. Intraoperative cytodiagnosis for detecting a minute invasion of the portal vein during pancreaticoduodenectomy for adenocarcinoma of the pancreatic head. Am J Surg. 1998;175:477–481.

    Article  CAS  PubMed  Google Scholar 

  24. Takahashi S, Ogata Y, Tsuzuki T. Combined resection of the pancreas and portal vein for pancreatic cancer. Br J Surg. 1994;81:1190–1193.

    CAS  PubMed  Google Scholar 

  25. Harrison LE, Klimstra DS, Brennan MF. Isolated portal vein involvement in pancreatic adenocarcinoma. A contraindication for resection? Ann Surg. 1996;224:342–349.

    Article  CAS  PubMed  Google Scholar 

  26. Allema JH, Reinders ME, van Gulik TM, et al. Portal vein resection in patients undergoing pancreaticoduodenectomy for carcinoma of the pancreatic head. Br J Surg. 1994;81:1642–1646.

    CAS  PubMed  Google Scholar 

  27. Roder JD, Stein HJ, Siewert JR. Carcinoma of the periampullary region: who benefits from portal vein resection? Am J Surg. 1996;171:170–175.

    Article  CAS  PubMed  Google Scholar 

Download references

Authors
  1. Charles R. Scoggins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ingrid M. Meszoely
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steven D. Leach
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Scott Pearson
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    Douglas B. Evans M.D. (Professor of Surgery) & Peter W. T. Pisters M.D., F.A.C.S. (Associate Professor of Surgery) (Professor of Surgery) &  (Associate Professor of Surgery)

  2. Department of Gastrointestinal Medical Oncology, The University Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA

    James L. Abbruzzese M.D. (Professor of Medical Oncology, Chairman) (Professor of Medical Oncology, Chairman)

Rights and permissions

Reprints and permissions

Copyright information

© 2002 Springer-Verlag New York, Inc.

About this chapter

Cite this chapter

Scoggins, C.R., Meszoely, I.M., Leach, S.D., Pearson, A.S. (2002). Vascular Resection and Reconstruction for Localized Pancreatic Cancer. In: Evans, D.B., Pisters, P.W.T., Abbruzzese, J.L. (eds) Pancreatic Cancer. M. D. Anderson Solid Tumor Oncology Series. Springer, New York, NY. https://doi.org/10.1007/0-387-21600-6_13

Download citation

  • DOI: https://doi.org/10.1007/0-387-21600-6_13

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-95185-0

  • Online ISBN: 978-0-387-21600-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation