Extended Pancreaticoduodenectomy Combined with Resection of the Involved Portal Vein/Superior Mesenteric Vein

Objective To explore the feasibility of radical resection for pancreatic head cancer involving portal vein(PV) and superior mesenteric vein(SMV).Methods The data of 11 cases with pancreatic head cancer involving PV/SMV underwent extended pancreaticoduodenectomy were analyzed retrospectively,including 7 cases of partial resection of the vascular wall,3 cases of segmental resection and end-to-end anastomosis,and 1 case of segmental resection followed by artificial graft transplantation.4 cases underwent end-to-side anastomosis of splenic vein and SMV,and 3 cases underwent splenic vein ligation.Child procedure was adopted for digestive tract reconstruction.Results The mean PV interruption time was 18.1(9～32) minutes.No embolization,intestinal necrosis or hepatic failure was found in the whole group.All cases were survived after operation and were followed up for 6 to 20 months.Median survival time was 15(7～20) months,3 cases died in 12 months after operation,4 cases lead a normal life more than 1 year,then died in 24 months after treatment.Conclusion It is feasible to perform extended pancreaticoduodenectomy for cases of pancreatic head carcinoma with involvement to PV/SMV.