Survival and Quality of Life after Surgical Treatment for Patients with Pancreatic Carcinoma-the Application of Coresection and Reconstruction of the Portal and Arterial Systems

Toshiyuki Takahashi, Hiroshi Sugiura, Kiyotaka Itoh, Koichi Ohno, Shun-ichi Okushiba and Hiroyuki Katoh

Second Department of Surgery, Hokkaido University School of Medicine

In this paper, long-term survival and quality of life after surgical treatment for patients with pancreatic carcinoma were studied, and the application of coresection of the portal and arterial systems was discussed. For the past decade, 126 patients with pancreatic carcinoma were admitted to our department 54% underwent total pancreatic resection. Coresection of only the portal system was performed in 36. 8%, and coresection of both the portal and arterial systems in 8.8% of the resected cases. No statistical difference was found in the morbidity, mortality, and long-term survival between patients with coresection of the portal system only and those without coresection of vessels. However, a high ratio of morbidity and mortality was noticed in patients with coresection of both the portal and arterial systems. Long-term survival in these patients, with the mean of 7 months, was lower than in patients with tumor removal without coresection of vessels. Furthermore, no statistical difference was found when compared with the long-term survival of unresectable patients. Additionaly, postoperative, non-hospital days for patients with both portal arterial coresection were no more than for unresected patients. These facts indicate that the prognosis of patients with portal invasion of pancreatic carcinoma can be improved by coresection of only the portal system. However, the authors emphasize that coresection of both the portal and arterial systems should not be applied in patients with tumor involvment of both systems.

Key words
pancreas cancer, coresection of the portal vein, reconstruction of the artery

Reprint requests
Toshiyuki Takahashi Second Department of Surgery, Hokkaido University School of Medicine N-15 W-7, Kita-ku, Sapporo, 060-8638 JAPAN

Accepted
January 27, 1999

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