Pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head with venous resection
, , oraz
19 lip 2016
O artykule
Kategoria artykułu: Research Article
Data publikacji: 19 lip 2016
Zakres stron: 321 - 328
Otrzymano: 17 gru 2014
Przyjęty: 26 mar 2015
DOI: https://doi.org/10.1515/raon-2015-0017
Słowa kluczowe
© 2016 Radiol Oncol
This content is free.
Figure 1
Figure 2
![Kaplan-Meier survival plot for patients with vein reconstruction (pacreaticoduodenectomy [PD]+ vein resection [VR]). Median survival time in months was in this group 16.1 months.](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6473549d4e662f30ba53a824/j_raon-2015-0017_fig_002.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20250916%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20250916T181938Z&X-Amz-Expires=3600&X-Amz-Signature=e99bd033ea40a7a95f37b4b882beea46ee0c4a46cfba0be87ed0ca8fd29962cf&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Figure 3
![Comparison of Kaplan-Meier survival plots for both groups. Median survival time in months was in group with vein resection (pacreaticoduodenectomy [PD]+ vein resection [VR]) 16.1 months (line B) and in group without vein resection (PD - VR) 15.2 months (line A). Five year survival in group without vein resection (line B) was 19.5%. Comparison of survival curves showed equal hazard rates with log-rank p = 0.090 (z = 1.659 at 5% C; C = 1.96).](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6473549d4e662f30ba53a824/j_raon-2015-0017_fig_003.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=AKIA6AP2G7AKOUXAVR44%2F20250916%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20250916T181938Z&X-Amz-Expires=3600&X-Amz-Signature=cbde66ce6d0b8c115eee8f62481aab70a8e3210d6043f438516ecbafc75941cc&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
TNM stage in 111 patients who underwent pancreaticoduodenectomy without vein resection in comparison with vein resection (VR) group_ There is no statistically important difference in N0 and N1 stage between both groups (P = 0_432, Fischer’s exact test, no statistical significance)_
| TNM stage | Without VR (n = 111) | With VR (n = 22) |
|---|---|---|
| T0 | 0 | 0 |
| T1 | 10 | 0 |
| T2 | 26 | 0 |
| T3 | 75 | 22 |
| T4 | 0 | 0 |
| N0 | 32 | 4 |
| N1 | 79 | 18 |
Resection margins of extirpated tumors_ There is no statistically important difference bewteen both groups (with or without venous resection [VR]) (Chi-square 2_79, p = 0_247)
| Resection margin | Without VR (n = 111) | With VR (n = 22) |
|---|---|---|
| R0 | 102 | 18 |
| R0,1 | 5 | 3 |
| R1 | 4 | 1 |
Selected clinical characteristics and preoperative data in patients undergoing pancreaticoduodenectomy with or without vein resection (VR)_ There is no statistically important differences between both groups
| Variable | Without VR (n = 111) | With VR (n = 22) | P-value test |
|---|---|---|---|
| Age (average years) | 65.6 ± 7.7 | 63.95 ± 9.5 | P = 0.45; t test |
| Sex (male:female) | 53:58 | 9:13 | P = 0.64; Chi square |
| 1 | 34 | 7 | |
| 2 | 61 | 12 | |
| 3 | 16 | 2 | |
| 4 | 0 | 0 | P = 0.83; Chi square |
| Below 100mmol/l | 77 | 18 | |
| Above 100mmol/l | 34 | 4 | P = 0.306; Chi square |
| Increased (> 5ng/l) | 30 | 5 | P = 0.795; Chi square |
| Increased (> 30IU/l) | 78 | 16 | P = 1.0; Chi square |
List of surgical complications developed after pancreatoduodenectomy_ Comparison between group without vein resection (PD [pacreaticoduodenectomy] - VR [vein resection]) and group with vein resection (PD + VR)
| Type of surgical complication | Without VR (n = 111) | With VR (n = 22) |
|---|---|---|
| Pancreatic fistula | 5 (4.5%) | 1 (4.5%) |
| Bile leak | 3 (2.7%) | 1 (4.5%) |
| Intraperitoneal bleeding | 6 (5.4%) | 0 |
| Abdominal abscess | 5 (4.5%) | 0 |
| Gastric emptying syndrome | 1 (0.9%) | 1 (4.5%) |
| Rupture of the laparatomy | 4 (3.6%) | 0 |
| Necrosing pancreatitis | 1 (0.9%) | 0 |
| Ileus of Roux-Y | 1 (0.9%) | 0 |
| Critical ischemia of the colon | 1 (0.9%) | 0 |
| Poral vein thrombosis | 0 | 1 (4.5%) |
| 60 day mortality | 5 (4.5%) | 1 (4.5%) |
Cause of intrahospital deaths between both groups_ (P = 1_0, Fischer’s exact test, no statistical significance in death rate)
| Cause of death | Without VR | With VR |
|---|---|---|
| Massive pulmonary embolia | 1 | 0 |
| Cerebrovascular insult | 1 | 0 |
| Myocardial infarction | 2 | 1 |
| Bronchopneumonia | 1 | 0 |