Erschienen in:
01.06.2015 | Pancreatic Tumors
Additional Support for Neoadjuvant Therapy in the Management of Pancreatic Cancer
verfasst von:
Kathleen K. Christians, MD, Douglas B. Evans, MD
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 6/2015
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Excerpt
The relationship of a pancreatic head cancer to the superior mesenteric–portal vein (SMPV) confluence has intrigued and confused surgeons and oncologists for decades. The foundation for this ongoing debate began with Whipple, who described the operation of pancreaticoduodenectomy (PD) in 1935; Moore and colleagues, who first described resection and reconstruction of the superior mesenteric vein (SMV) in 1951; and Fortner, who reported his experience with regional pancreatectomy in 1973. Fortner routinely divided the distal splenic vein when performing segmental resection of the SMPV confluence, allowing for a primary end-to-end anastomosis of the SMV and portal vein (PV).
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3 However, the failure of regional pancreatectomy to positively influence survival duration caused most to dismiss venous resection as an ineffective, high-risk, and therefore overaggressive approach to a disease that is often metastatic at diagnosis. …
