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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

NORERO M, ENRIQUE et al. Pancreaticoduodenectomy with vascular resection. Perioperative results and long-term survival. Rev Chil Cir [online]. 2009, vol.61, n.6, pp.519-525. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262009000600005.

Background: Pancreaticoduodenectomy (PDD) with vascular resection (VR) of the portal and superior mesenteric vein for locally advanced periampullary tumors is controversial. Aim: To evaluate the perioperative results and long-term survival of PDD with VR. Patients and Methods: Retrospective study. We included patients with periampullary tumors who underwent a PDD with VR between 1990 and 2008. We compared perioperative results and long-term survival with PDD without VR during the same period. We compared survival with non resected patients. Results: One hundred and eighty eight patients underwent a PDD, a VR was performed in 8 (4%) patients (Age: 58 ± 14 years, Male: 4). Morbidity for PDD with and without VR was 75% and 59% (p = ns). Surgical mortality for PDD with and without VR was 0% and 8% (p = ns). In 6 of 8 patients the diagnosis was pancreatic cancer and histopathologic confirmation of vascular invasion was present in 4 patients. Long-term survival for patients with PDD with and without VR was similar (median 25 and 16 months; p = ns). Survival for patients with PDD with VR was superior to non resected patients (median 25 and 3 months; p = 0.0001). Conclusions: PDD with VR has similar perioperative results and long-term survival to PDD without VR. The survival reached with this type of surgery is far superior to non resected patients.

Palabras clave : Periampullary tumor; pancreatic cancer; pancreaticoduodenectomy; Whipple; portal vein; superior mesenteric vein.

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