Abstract
Background:1.It is believed that arterial involvement in pancreatic cancer (PC) is a sign of so far advanced disease that pancreatic resection(PR) is meaningless;2.Distal pancreatectomy(DP) with celiac artery resection(DPCAR) is justified option for locally advanced PC Aim: Assessment of the rates of morbidity, mortality, true pathological artery involvement and R0- resections, overall and disease-free survival after PRs with celiac (CA) and/or common hepatic artery (CHA) resections(AR). Patients and methods: Patients with pancreatic ductal adenocarcinoma (n33) and neuroendocrine cancer(n5) underwent 38 PRs with AR without preoperative occlusion of CHA, 36 without arterial reconstructions(2009-2019). Age 54-76y. ECOG-0-1. Adjuvant chemotherapy,n19, neoadjuvant,n11 with better tendency. IOUS and vascular fluorescence (ICG) were there main methods for assessment of liver and stomach ischemia. Results: The rate of pathological CA/CHA involvement - 100%. Overall rate of R0-resections 87%, for PDAC 85%, vein resections during DPCAR -12(35%). Morbidity: 18 (47%), pancreatic fistula Grade B/C -14(41%), mortality- 2 (5,3%), median OS- 24 months, median DFS -18 months, overall 5-y survival -41%, actual 5-y survival - 13%. No liver and bowel ischemia, gastric ischemia - 15% (1 perfor ation). All the relapses were distant. Conclusion: Neoadjuvant treatment and R0-resection with acceptable morbidity and mortality rates justifies arterial resections for PDAC.
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call