Analysis of a series of 100 mesenterico-portal vein resections during pancreatic resection

Pancreatic resection is currently the only treatment offering the possibility of long-term survival for patients with pancreatic cancer. Mesentericoportal vein involvement used to be considered a contraindication to pancreatic resection, but recent advances in vascular surgery have gradually extended the indications of curative pancreatic resection to such cases. We report hereby our experience of 100 pancreatic resections combined with mesentericoportal vein resection for pancreatic malignancies, performed between 1989 and 2005. This is one of the largest reported series. The overall mortality rate was 4% and the morbidity rate was 39%. Among the 76 patients who had pancreatic adenocarcinoma, the 5-year survival rate in case of limited mesenterico-portal vein wall involvement (up to the adventitia) was similar to that among patients without histological involvement of the portal vein wall (35.8% and 26.7%, respectively). These results support aggressive management consisting of resection and reconstruction of the mesentericoportal veins inpatients with venous involvement, provided curative R-0 resection is feasible.