Clinical value and surgical method of the pancreatic cancer with PV/SMV invasion

Abstract

Objective To investigate the clinical value and surgical methods of pancreaticoduodenectomy (PD) combined with portal vein (PV)/superior mesenteric vein (SMV) resection and reconstruction in the treatment of pancreatic cancer with PV/SMV invaded by tumor. Methods The clinical data of 21 patients of pancreatic cancer with PV/SMV invaded by tumor (group A) and 62 patients of pancreatic head cancer without PV/SMV invaded by tumor (group B) in the same period were collected and analyzed retrospectively from Jan 2014 to Apr 2017. There were no distinct invasion of celiac artery (CA), hepatic common artery (HCA) and superior mesenteric artery (SMA) in two groups of pancreatic cancer patients. The patients of group A underwent PD combined with PV/SMV resection and reconstruction, and the patients of group B were only treated with PD surgery. The complication rate and overall survival time after PD was compared between the 21 patients of pancreatic cancer with PV/SMV invaded by tumor and the 62 patients of pancreatichead cancer without PV/SMV invaded by tumor. ' Results The average overall survival time of 21 patients of pancreatic cancer with PV/SMV invaded by tumor (group A) was 19.2 months, specifically with 1-year survival rate of 57.1% (12/21), 2-year survival rate of 28.6% (6/21), and 3-year survival rate of 14.3% (3/21). Meanwhile, the average overall survival time of group B was 19.4 months, specifically with 1-year survival rate of 58.1% (36/62), 2-year survival rate of 30.6% (19/62), and 3-year survival rate of 14.5% (9/62). The results indicated that no differences for overall survival time of patients treated with PD including 1, 2, 3-year survival rate between two groups were found (P>0.05). Conclusions For pancreatic cancer accompanied by PV/SMV invasion without invasion of SMA, CA and HCA, PD combined with PV/SMV resection and reconstruction are safe and feasible surgical procedures. The surgical reconstruction method was determined according to the location and length of the invaded vessels, and also there were no significant differences on the complication rate and overall survival time after PD between the pancreatic cancer patients with invasion of PV/SMV and the pancreatic head cancer patients without invasion of PV/SMV. Key words: Pancreatic neoplasms; Pancreaticoduodenectomy; Vascular surgical procedures; Prognosis