Detailed Abstract
[Poster Presentation 12 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP PP 12-S3] Examination of Portal Vein Stenosis And Its Impact after Pancreaticoduodenectomy And Distal Pancreatectomy with Portal Vein Resection for Pancreatic Ductal Adenocarcinoma.
Hidetaka MIYAZAKI 1, Sohei SATOI 1, Daisuke HASHIMOTO 1, So YAMAKI 1, Kazuki MATSUMURA 1, Yuki MATSUI 1, Denys TSYBULSKYI 1, Sang NGUYEN 1, Mitsugu SEKIMOTO 1
1 Surgery, Kansai Medical University, JAPAN
Background : Advancements in multimodal treatment have expanded the surgical indications for pancreatic ductal adenocarcinoma(PDAC). Although pancreaticoduodenectomy(PD) with portal vein resection(PVR) has become widely adopted, distal pancreatectomy(DP) with PVR remain rarely performed because of technical complexity. Recently, Maekawa et al. clearly revealed higher occlusion and postoperative complication rated after DP-PVR relative to PD-PVR(Ann Surg Oncol 2023). We aimed to investigate portal vein stenosis and its impact after PD-PVR and DP-PVR in our institution.
Methods : A single-center retrospective study included 214 patients with PDAC who underwent pancreatectomy with PVR between 2007 and 2023. Clinical backgrounds, surgical outcome, and survival were compared between PD-PVR and DP-PVR.
Results : Of 20(9.3%) underwent DP-PVR including 5 DP-CARs and 194(90.7%) underwent PD-PVR. There were no significant differences in clinical characteristics(sex, age, ASA-PS, BMI, etc). The proportion of preoperative chemotherapy, CA19-9, tumor size, and resectability were also similar. There were no differences in RFS(median 34.4 vs 16 months; p=0.293) and OS(median 49.5 vs 41.4 months; p=0.085) between DP-PVR and PD-PVR.The length of PVR did not differ between two groups(DP-PVR;12.5 vs PD-PVR;15mm in median p=0.341). However, PV >50% stenosis and complete PV occlusion occurred more frequently in DP-PVR than in PD-PVR(50% vs 17.5%; p=0.002, and 40% vs 8.8%; p<0.001). In recurrence related stenosis and occlusion, results were also same.The duration of PV stenosis and occlusion did not differ between DP-PVR and PD-PVR(median 84 vs 22 days; p=0.654 and 84 vs 76 days; p=0.275).
Conclusions : As Maekawa et al. already showed higher PV occlusion and stenosis rates were found after DP-PVR than PD-PVR.
Methods : A single-center retrospective study included 214 patients with PDAC who underwent pancreatectomy with PVR between 2007 and 2023. Clinical backgrounds, surgical outcome, and survival were compared between PD-PVR and DP-PVR.
Results : Of 20(9.3%) underwent DP-PVR including 5 DP-CARs and 194(90.7%) underwent PD-PVR. There were no significant differences in clinical characteristics(sex, age, ASA-PS, BMI, etc). The proportion of preoperative chemotherapy, CA19-9, tumor size, and resectability were also similar. There were no differences in RFS(median 34.4 vs 16 months; p=0.293) and OS(median 49.5 vs 41.4 months; p=0.085) between DP-PVR and PD-PVR.The length of PVR did not differ between two groups(DP-PVR;12.5 vs PD-PVR;15mm in median p=0.341). However, PV >50% stenosis and complete PV occlusion occurred more frequently in DP-PVR than in PD-PVR(50% vs 17.5%; p=0.002, and 40% vs 8.8%; p<0.001). In recurrence related stenosis and occlusion, results were also same.The duration of PV stenosis and occlusion did not differ between DP-PVR and PD-PVR(median 84 vs 22 days; p=0.654 and 84 vs 76 days; p=0.275).
Conclusions : As Maekawa et al. already showed higher PV occlusion and stenosis rates were found after DP-PVR than PD-PVR.
SESSION
Poster Presentation 12
Zone F 3/22/2024 2:50 PM - 3:40 PM