Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience

Hryhoriy Lapshyn; Theresa Schulte; Natalie Petruch; Ekaterina Petrova; Kim Honselmann; Steffen Deichmann; Rüdiger Braun; Birte Kulemann; Jens Hoeppner; Dirk Rades; Tobias Keck; Ulrich F Wellner; Dirk Bausch; Louisa Bolm

doi:10.21873/anticanres.15329

Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience

Hryhoriy Lapshyn, Theresa Schulte, Natalie Petruch, Ekaterina Petrova, Kim Honselmann, Steffen Deichmann, Rüdiger Braun, Birte Kulemann, Jens Hoeppner, Dirk Rades, Tobias Keck, Ulrich F Wellner, Dirk Bausch, Louisa Bolm

Abstract

BACKGROUND/AIM: The impact of venous resections and reconstruction techniques on morbidity after surgery for pancreatic cancer (PDAC) remains controversial.

PATIENTS AND METHODS: A total of 143 patients receiving pancreatoduodenectomy (PD) for PDAC between 2013 and 2018 were identified from a prospective database. Morbidity and mortality after PD with tangential resection versus end-to-end reconstruction were assessed.

RESULTS: Fifty-two of 143 (36.4%) patients underwent PD with portal venous resection (PVR), which was associated with longer operation times [398 (standard error (SE) 12.01) vs. 306 (SE 13.09) min, p<0.001]. PVR was associated with longer intensive-care-unit stay (6.3 vs. 3.8 days, p=0.054); morbidity (Clavien-Dindo classification (CDC) grade IIIa-V 45.8% vs. 35.8%, p=0.279) and 30-day mortality (4.1% vs. 4.2%, p>0.99) were not different. Tangential venous resection was associated with similar CDC grade IIIa-IV (42.9% vs. 50.0%, p=0.781) and 30-day mortality rates (3.5% vs. 4.1%, p=0.538) as segmental resection and end-to-end venous reconstruction.

CONCLUSION: Both tangential and segmental PVR appear feasible and can be safely performed to achieve negative resection margins.

Original language	English
Journal	Anticancer Research
Volume	41
Issue number	10
Pages (from-to)	5123-5130
Number of pages	8
ISSN	0250-7005
DOIs	https://doi.org/10.21873/anticanres.15329
Publication status	Published - 2021

Research Areas and Centers

Centers: University Cancer Center Schleswig-Holstein (UCCSH)
Research Area: Luebeck Integrated Oncology Network (LION)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Lapshyn, H., Schulte, T., Petruch, N., Petrova, E., Honselmann, K., Deichmann, S., Braun, R., Kulemann, B., Hoeppner, J., Rades, D., Keck, T., Wellner, U. F., Bausch, D., & Bolm, L. (2021). Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience. Anticancer Research, 41(10), 5123-5130. https://doi.org/10.21873/anticanres.15329

@article{9158ba1bab0e43f48917fbf7a3a021d6,

title = "Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience",

abstract = "BACKGROUND/AIM: The impact of venous resections and reconstruction techniques on morbidity after surgery for pancreatic cancer (PDAC) remains controversial.PATIENTS AND METHODS: A total of 143 patients receiving pancreatoduodenectomy (PD) for PDAC between 2013 and 2018 were identified from a prospective database. Morbidity and mortality after PD with tangential resection versus end-to-end reconstruction were assessed.RESULTS: Fifty-two of 143 (36.4%) patients underwent PD with portal venous resection (PVR), which was associated with longer operation times [398 (standard error (SE) 12.01) vs. 306 (SE 13.09) min, p<0.001]. PVR was associated with longer intensive-care-unit stay (6.3 vs. 3.8 days, p=0.054); morbidity (Clavien-Dindo classification (CDC) grade IIIa-V 45.8% vs. 35.8%, p=0.279) and 30-day mortality (4.1% vs. 4.2%, p>0.99) were not different. Tangential venous resection was associated with similar CDC grade IIIa-IV (42.9% vs. 50.0%, p=0.781) and 30-day mortality rates (3.5% vs. 4.1%, p=0.538) as segmental resection and end-to-end venous reconstruction.CONCLUSION: Both tangential and segmental PVR appear feasible and can be safely performed to achieve negative resection margins.",

author = "Hryhoriy Lapshyn and Theresa Schulte and Natalie Petruch and Ekaterina Petrova and Kim Honselmann and Steffen Deichmann and R{\"u}diger Braun and Birte Kulemann and Jens Hoeppner and Dirk Rades and Tobias Keck and Wellner, {Ulrich F} and Dirk Bausch and Louisa Bolm",

year = "2021",

doi = "10.21873/anticanres.15329",

language = "English",

volume = "41",

pages = "5123--5130",

journal = "Anticancer Research",

issn = "0250-7005",

number = "10",

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Lapshyn, H, Schulte, T, Petruch, N, Petrova, E, Honselmann, K, Deichmann, S , Braun, R, Kulemann, B, Hoeppner, J , Rades, D , Keck, T , Wellner, UF, Bausch, D & Bolm, L 2021, 'Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience', Anticancer Research, vol. 41, no. 10, pp. 5123-5130. https://doi.org/10.21873/anticanres.15329

Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience. / Lapshyn, Hryhoriy; Schulte, Theresa; Petruch, Natalie et al.
In: Anticancer Research, Vol. 41, No. 10, 2021, p. 5123-5130.

Research output: Journal Articles › Journal articles › Research › peer-review

TY - JOUR

T1 - Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma

T2 - A Single-Center Experience

AU - Lapshyn, Hryhoriy

AU - Schulte, Theresa

AU - Petruch, Natalie

AU - Petrova, Ekaterina

AU - Honselmann, Kim

AU - Deichmann, Steffen

AU - Braun, Rüdiger

AU - Kulemann, Birte

AU - Hoeppner, Jens

AU - Rades, Dirk

AU - Keck, Tobias

AU - Wellner, Ulrich F

AU - Bausch, Dirk

AU - Bolm, Louisa

PY - 2021

Y1 - 2021

N2 - BACKGROUND/AIM: The impact of venous resections and reconstruction techniques on morbidity after surgery for pancreatic cancer (PDAC) remains controversial.PATIENTS AND METHODS: A total of 143 patients receiving pancreatoduodenectomy (PD) for PDAC between 2013 and 2018 were identified from a prospective database. Morbidity and mortality after PD with tangential resection versus end-to-end reconstruction were assessed.RESULTS: Fifty-two of 143 (36.4%) patients underwent PD with portal venous resection (PVR), which was associated with longer operation times [398 (standard error (SE) 12.01) vs. 306 (SE 13.09) min, p<0.001]. PVR was associated with longer intensive-care-unit stay (6.3 vs. 3.8 days, p=0.054); morbidity (Clavien-Dindo classification (CDC) grade IIIa-V 45.8% vs. 35.8%, p=0.279) and 30-day mortality (4.1% vs. 4.2%, p>0.99) were not different. Tangential venous resection was associated with similar CDC grade IIIa-IV (42.9% vs. 50.0%, p=0.781) and 30-day mortality rates (3.5% vs. 4.1%, p=0.538) as segmental resection and end-to-end venous reconstruction.CONCLUSION: Both tangential and segmental PVR appear feasible and can be safely performed to achieve negative resection margins.

AB - BACKGROUND/AIM: The impact of venous resections and reconstruction techniques on morbidity after surgery for pancreatic cancer (PDAC) remains controversial.PATIENTS AND METHODS: A total of 143 patients receiving pancreatoduodenectomy (PD) for PDAC between 2013 and 2018 were identified from a prospective database. Morbidity and mortality after PD with tangential resection versus end-to-end reconstruction were assessed.RESULTS: Fifty-two of 143 (36.4%) patients underwent PD with portal venous resection (PVR), which was associated with longer operation times [398 (standard error (SE) 12.01) vs. 306 (SE 13.09) min, p<0.001]. PVR was associated with longer intensive-care-unit stay (6.3 vs. 3.8 days, p=0.054); morbidity (Clavien-Dindo classification (CDC) grade IIIa-V 45.8% vs. 35.8%, p=0.279) and 30-day mortality (4.1% vs. 4.2%, p>0.99) were not different. Tangential venous resection was associated with similar CDC grade IIIa-IV (42.9% vs. 50.0%, p=0.781) and 30-day mortality rates (3.5% vs. 4.1%, p=0.538) as segmental resection and end-to-end venous reconstruction.CONCLUSION: Both tangential and segmental PVR appear feasible and can be safely performed to achieve negative resection margins.

U2 - 10.21873/anticanres.15329

DO - 10.21873/anticanres.15329

M3 - Journal articles

C2 - 34593463

SN - 0250-7005

VL - 41

SP - 5123

EP - 5130

JO - Anticancer Research

JF - Anticancer Research

IS - 10

ER -

Lapshyn H, Schulte T, Petruch N, Petrova E, Honselmann K, Deichmann S et al. Postoperative Outcomes of Tangential versus Segmental Resection and End-to-end Reconstruction of the Superior Mesenterico-Portal Vein During Pancreatoduodenectomy for Pancreatic Adenocarcinoma: A Single-Center Experience. Anticancer Research. 2021;41(10):5123-5130. doi: 10.21873/anticanres.15329