Skip to main content
Erschienen in: Journal of Hepato-Biliary-Pancreatic Sciences 2/2012

01.03.2012 | Topics

Portal vein resection in pancreaticoduodenectomy (with video)

verfasst von: Hodaka Amano, Fumihiko Miura, Tadahiro Takada, Keiji Sano

Erschienen in: Journal of Hepato-Biliary-Pancreatic Sciences | Ausgabe 2/2012

Einloggen, um Zugang zu erhalten

Abstract

Superior mesenteric vein (SMV) resection during pancreaticoduodenectomy (PD) for pancreatic cancer was first reported by Moore in 1951. In Japan, utilization of portal vein resection (PVR) became popular beginning in the late 1970s and has resulted in an improved resection rate for pancreatic cancer. Outcomes of PVR differ according to the reported year and institution. In a recent report of meta-analysis, there was no difference in outcomes after PVR if R0 (negative surgical margins) resection was possible. Pancreatic surgery including vascular resection must be re-evaluated in light of recent advances in diagnostic imaging and surgical techniques, lower mortality and morbidity after PVR, and improvements in adjuvant and neo-adjuvant therapy. Isolated portal vein involvement should not be a contraindication to resection. Portal vein resection should be considered after appropriate patient selection based on an accurate diagnosis, provided that safe R0 resection is possible. We describe technical details and considerations for PVR during PD in this paper.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Moore GE, Sako Y, Thomas LB. Radical pancreatoduodenectomy with resection and reanastomosis of the superior mesenteric vein. Surgery. 1951;30:550–3.PubMed Moore GE, Sako Y, Thomas LB. Radical pancreatoduodenectomy with resection and reanastomosis of the superior mesenteric vein. Surgery. 1951;30:550–3.PubMed
2.
Zurück zum Zitat Imaizumi T, Hanyu F, Harada N, Hatori T, Fukuda A. Extended radical Whipple resection for cancer of the pancreatic head: operative procedure and results. Dig Surg. 1998;15:299–307.PubMedCrossRef Imaizumi T, Hanyu F, Harada N, Hatori T, Fukuda A. Extended radical Whipple resection for cancer of the pancreatic head: operative procedure and results. Dig Surg. 1998;15:299–307.PubMedCrossRef
3.
Zurück zum Zitat Nakao A, Takeda S, Inoue S, Nomoto S, Kanazumi N, Sugimoto H, et al. Indications and techniques of extended resection for pancreatic cancer. World J Surg. 2006;30:976–82. Discussion 983–984.PubMedCrossRef Nakao A, Takeda S, Inoue S, Nomoto S, Kanazumi N, Sugimoto H, et al. Indications and techniques of extended resection for pancreatic cancer. World J Surg. 2006;30:976–82. Discussion 983–984.PubMedCrossRef
4.
Zurück zum Zitat Matsuno S, Egawa S, Fukuyama S, Motoi F, Sunamura M, Isaji S, et al. Pancreatic Cancer Registry in Japan: 20 years of experience. Pancreas. 2004;28:219–30.PubMedCrossRef Matsuno S, Egawa S, Fukuyama S, Motoi F, Sunamura M, Isaji S, et al. Pancreatic Cancer Registry in Japan: 20 years of experience. Pancreas. 2004;28:219–30.PubMedCrossRef
6.
Zurück zum Zitat Bachellier P, Nakano H, Oussoultzoglou PD, Weber JC, Boudjema K, Wolf PD, et al. Is pancreaticoduodenectomy with mesentericoportal venous resection safe and worthwhile? Am J Surg. 2001;182:120–9.PubMedCrossRef Bachellier P, Nakano H, Oussoultzoglou PD, Weber JC, Boudjema K, Wolf PD, et al. Is pancreaticoduodenectomy with mesentericoportal venous resection safe and worthwhile? Am J Surg. 2001;182:120–9.PubMedCrossRef
7.
Zurück zum Zitat Poon RT, Fan ST, Lo CM, Liu CL, Lam CM, Yuen WK, Yeung C, Wong J. Pancreaticoduodenectomy with en bloc portal vein resection for pancreatic carcinoma with suspected portal vein involvement. World J Surg. 2004;28:602–8.PubMedCrossRef Poon RT, Fan ST, Lo CM, Liu CL, Lam CM, Yuen WK, Yeung C, Wong J. Pancreaticoduodenectomy with en bloc portal vein resection for pancreatic carcinoma with suspected portal vein involvement. World J Surg. 2004;28:602–8.PubMedCrossRef
8.
Zurück zum Zitat Yekebas EF, Bogoevski D, Cataldegirmen G, Kunze C, Marx A, Vashist YK, et al. En bloc vascular resection for locally advanced pancreatic malignancies infiltrating major blood vessels: perioperative outcome and long-term survival in 136 patients. Ann Surg. 2008;247:300–9.PubMedCrossRef Yekebas EF, Bogoevski D, Cataldegirmen G, Kunze C, Marx A, Vashist YK, et al. En bloc vascular resection for locally advanced pancreatic malignancies infiltrating major blood vessels: perioperative outcome and long-term survival in 136 patients. Ann Surg. 2008;247:300–9.PubMedCrossRef
9.
Zurück zum Zitat Christians KK, Lal A, Pappas S, Quebbeman E, Evans DB. Portal vein resection. Surg Clin N Am. 2010;90:309–22.PubMedCrossRef Christians KK, Lal A, Pappas S, Quebbeman E, Evans DB. Portal vein resection. Surg Clin N Am. 2010;90:309–22.PubMedCrossRef
10.
Zurück zum Zitat Nakamura S, Hachiya T, Oonuki Y, Sakaguchi S, Konno H, Baba S. A new technique for avoiding difficulty during reconstruction of the superior mesenteric vein. Surg Gynecol Obstet. 1993;177:521–3.PubMed Nakamura S, Hachiya T, Oonuki Y, Sakaguchi S, Konno H, Baba S. A new technique for avoiding difficulty during reconstruction of the superior mesenteric vein. Surg Gynecol Obstet. 1993;177:521–3.PubMed
11.
Zurück zum Zitat Cusack JC Jr, Fuhrman GM, Lee JE, Evans DB. Managing unsuspected tumor invasion of the superior mesenteric-portal venous confluence during pancreaticoduodenectomy. Am J Surg. 1994;168:352–4.PubMedCrossRef Cusack JC Jr, Fuhrman GM, Lee JE, Evans DB. Managing unsuspected tumor invasion of the superior mesenteric-portal venous confluence during pancreaticoduodenectomy. Am J Surg. 1994;168:352–4.PubMedCrossRef
12.
Zurück zum Zitat Suzuki T, Yoshidome H, Kimura F, Shimizu H, Ohtsuka M, Kato A, et al. Renal function is well maintained after use of left renal vein graft for vascular reconstruction in hepatobiliary-pancreatic surgery. J Am Coll Surg. 2006;202:87–92.PubMedCrossRef Suzuki T, Yoshidome H, Kimura F, Shimizu H, Ohtsuka M, Kato A, et al. Renal function is well maintained after use of left renal vein graft for vascular reconstruction in hepatobiliary-pancreatic surgery. J Am Coll Surg. 2006;202:87–92.PubMedCrossRef
13.
Zurück zum Zitat Stauffer JA, Dougherty MK, Kim GP, Nguyen JH. Interposition graft with polytetrafluoroethylene for mesenteric and portal vein reconstruction after pancreaticoduodenectomy. Br J Surg. 2009;96:247–52.PubMedCrossRef Stauffer JA, Dougherty MK, Kim GP, Nguyen JH. Interposition graft with polytetrafluoroethylene for mesenteric and portal vein reconstruction after pancreaticoduodenectomy. Br J Surg. 2009;96:247–52.PubMedCrossRef
14.
Zurück zum Zitat Chu CK, Farnell MB, Nguyen JH, Stauffer JA, Kooby DA, Sclabas GM, et al. Prosthetic graft reconstruction after portal vein resection in pancreaticoduodenectomy: a multicenter analysis. J Am Coll Surg. 2010;211:316–24.PubMedCrossRef Chu CK, Farnell MB, Nguyen JH, Stauffer JA, Kooby DA, Sclabas GM, et al. Prosthetic graft reconstruction after portal vein resection in pancreaticoduodenectomy: a multicenter analysis. J Am Coll Surg. 2010;211:316–24.PubMedCrossRef
15.
Zurück zum Zitat Fujisaki S, Tomita R, Fukuzawa M. Utility of mobilization of the right colon and the root of the mesentery for avoiding vein grafting during reconstruction of the portal vein. J Am Coll Surg. 2001;193:576–8.PubMedCrossRef Fujisaki S, Tomita R, Fukuzawa M. Utility of mobilization of the right colon and the root of the mesentery for avoiding vein grafting during reconstruction of the portal vein. J Am Coll Surg. 2001;193:576–8.PubMedCrossRef
16.
Zurück zum Zitat Katz MH, Fleming JB, Pisters PW, Lee JE, Evans DB. Anatomy of the superior mesenteric vein with special reference to the surgical management of first-order branch involvement at pancreaticoduodenectomy. Ann Surg. 2008;248:1098–102.PubMedCrossRef Katz MH, Fleming JB, Pisters PW, Lee JE, Evans DB. Anatomy of the superior mesenteric vein with special reference to the surgical management of first-order branch involvement at pancreaticoduodenectomy. Ann Surg. 2008;248:1098–102.PubMedCrossRef
17.
Zurück zum Zitat Asada S, Itaya H, Nakamura K, Isohashi T, Masuoka S. Radical pancreatectomy and portal vein resection. report of two successful cases with transplantation of portal vein. Arch Surg. 1963;87:609–13.PubMedCrossRef Asada S, Itaya H, Nakamura K, Isohashi T, Masuoka S. Radical pancreatectomy and portal vein resection. report of two successful cases with transplantation of portal vein. Arch Surg. 1963;87:609–13.PubMedCrossRef
18.
Zurück zum Zitat Sigel B, Bassett JG, Cooper D, Dunn MR. Resection of the superior mesenteric vein and replacement with a venous autograft during pancreaticoduodenectomy: case report. Ann Surg. 1985;162:941–5.CrossRef Sigel B, Bassett JG, Cooper D, Dunn MR. Resection of the superior mesenteric vein and replacement with a venous autograft during pancreaticoduodenectomy: case report. Ann Surg. 1985;162:941–5.CrossRef
19.
Zurück zum Zitat Longmire WP Jr, Longmire WP Jr. The technique of pancreaticoduodenal resection. Surgery. 1966;59:344–52.PubMed Longmire WP Jr, Longmire WP Jr. The technique of pancreaticoduodenal resection. Surgery. 1966;59:344–52.PubMed
20.
Zurück zum Zitat Fortner JG. Regional resection of cancer of the pancreas. A new surgical approach. Surgery. 1973;73:307–20.PubMed Fortner JG. Regional resection of cancer of the pancreas. A new surgical approach. Surgery. 1973;73:307–20.PubMed
21.
Zurück zum Zitat Siriwardana HP, Siriwardena AK. Systematic review of outcome of synchronous portal-superior mesenteric vein resection during pancreatectomy for cancer. Br J Surg. 2006;93:662–73.PubMedCrossRef Siriwardana HP, Siriwardena AK. Systematic review of outcome of synchronous portal-superior mesenteric vein resection during pancreatectomy for cancer. Br J Surg. 2006;93:662–73.PubMedCrossRef
22.
Zurück zum Zitat Muller SA, Hartel M, Mehrabi A, Welsch T, Martin DJ, Hinz U, et al. Vascular resection in pancreatic cancer surgery: survival determinants. J Gastrointest Surg. 2009;13:784–92.PubMedCrossRef Muller SA, Hartel M, Mehrabi A, Welsch T, Martin DJ, Hinz U, et al. Vascular resection in pancreatic cancer surgery: survival determinants. J Gastrointest Surg. 2009;13:784–92.PubMedCrossRef
23.
Zurück zum Zitat Ramacciato G, Mercantini P, Petrucciani N, Giaccaglia V, Nigri G, Ravaioli M, et al. Does portal-superior mesenteric vein invasion still indicate irresectability for pancreatic carcinoma? Ann Surg Oncol. 2009;16:817–25.PubMedCrossRef Ramacciato G, Mercantini P, Petrucciani N, Giaccaglia V, Nigri G, Ravaioli M, et al. Does portal-superior mesenteric vein invasion still indicate irresectability for pancreatic carcinoma? Ann Surg Oncol. 2009;16:817–25.PubMedCrossRef
24.
Zurück zum Zitat Chua TC, Saxena A. Extended pancreaticoduodenectomy with vascular resection for pancreatic cancer: a systematic review. J Gastrointest Surg. 2010;14:1442–52.PubMedCrossRef Chua TC, Saxena A. Extended pancreaticoduodenectomy with vascular resection for pancreatic cancer: a systematic review. J Gastrointest Surg. 2010;14:1442–52.PubMedCrossRef
Metadaten
Titel
Portal vein resection in pancreaticoduodenectomy (with video)
verfasst von
Hodaka Amano
Fumihiko Miura
Tadahiro Takada
Keiji Sano
Publikationsdatum
01.03.2012
Verlag
Springer Japan
Erschienen in
Journal of Hepato-Biliary-Pancreatic Sciences / Ausgabe 2/2012
Print ISSN: 1868-6974
Elektronische ISSN: 1868-6982
DOI
https://doi.org/10.1007/s00534-011-0468-4

Weitere Artikel der Ausgabe 2/2012

Journal of Hepato-Biliary-Pancreatic Sciences 2/2012 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.