Past
Portomesenteric venous resection (PVR) has become a standardized procedure in the field of pancreatic cancer surgery, owing to centralization, improved surgical techniques, and increasing use of preoperative chemotherapy.1,2 Because approximately two-thirds of the pancreatic adenocarcinomas are located in the pancreatic head, pancreatoduodenectomy (PD) with PVR is mostly performed in case of involvement of the portomesenteric venous axis, associated with similar surgical risks compared with standard PD.1,3 However, evidence about pancreatic adenocarcinoma located in the pancreatic body requiring a distal pancreatectomy (DP) combined with PVR is limited, comprising solely single-center series.4
Present
The current international retrospective study aimed to provide insight into the surgical outcome of DP-PVR compared to standard DP (2018–2020) for patients with pancreatic adenocarcinoma, using four audits from North America, Germany, Sweden, and the Netherlands.5 A total of 2924 patients were included who underwent DP for pancreatic adenocarcinoma of whom 241 patients (8.2%) underwent DP-PVR. Performing PVR was associated with an increased risk of developing in-hospital/30-day major morbidity, whereas concomitant PVR was not associated with in-hospital/30-day mortality.
Anzeige
Future
This largest study on DP ± PVR for patients with pancreatic adenocarcinoma demonstrated that DP-PVR is associated with increased morbidity but can be performed safely in terms of mortality. Future studies on patients with pancreatic adenocarcinoma located in the pancreatic body should investigate the short- and long-term surgical and oncological outcomes, comparing DP-PVR with both extended PD-PVR and total pancreatectomy (TP) with PVR.
Acknowledgement
For Global Audits on Pancreatic Surgery Group (GAPASURG): Bergthor Björnsson, MD, PhD9; Bobby Tingstedt, MD, PhD5; Christopher L. Wolfgang, MD, PhD, FACS11; Jens Werner, MD, PhD12; Karin Johansen, MD, PhD9; Martijn W.J. Stommel, MD, PhD13; Matthew H.G. Katz, MD, PhD14; Michael Ghadimi, MD, PhD15; Michael G. House, MD16; I. Quintus Molenaar, MD, PhD17; Roeland F. de Wilde, MD, PhD18; J. Sven D. Mieog, MD, PhD6; Tobias Keck, MD, PhD7; Tara M. Mackay, MD, PhD2,3; Salvador Rodriguez Franco, MD1; Susan van Dieren, MSc, PhD2
Disclosure
(1) Marco Del Chiaro has been awarded with an industry grant (Haemonetics, Inc) to conduct a multicenter study to evaluate the prognostic implications of TEG in pancreatic cancer; (2) Marco Del Chiaro is co-principal investigator of a Boston Scientific sponsored international multicenter study on the use of intraoperative pancreatoscopy of patients with IPMN.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
