Nicolae Bacalbasa1,2,3, Adina Croitoru3,4, Irina Balescu5, Simona Dima3, Vladislav Brasoveanu3,4, Mihaela Vilcu1,2, Iulian Brezean1,2. 1. "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. 2. "I. Cantacuzino" Clinical Hospital, Bucharest, Romania. 3. "Fundeni" Clinical Institute - Center of Excellence in Translational Medicine, Bucharest, Romania. 4. "Titu Maiorescu" University, Bucharest, Romania. 5. "Ponderas" Academic Hospital, Bucharest, Romania irina.balescu@ponderas-ah.ro.
Abstract
BACKGROUND/AIM: Pancreatic cancer remains asymptomatic for a long period of time, being frequently diagnosed when vascular invasion is already present. Such cases are widely known as borderline lesions. The aim of this study was to identify the effectiveness of vascular resection in this subgroup of patients. PATIENTS AND METHODS: Fifteen such cases were submitted to surgery with curative intent. RESULTS: Eight cases were diagnosed with borderline resectable lesions with portal vein invasion and were submitted to per primam resection and seven cases were initially diagnosed with arterial invasion and had been initially submitted to neoadjuvant chemotherapy followed by resection. In all cases portal vein resection was needed while in other four cases association of superior mesenteric artery resection was performed. Postoperatively, five patients developed complications requiring reoperation, three of whom died at the end of the first postoperative month. The histopathological studies confirmed the completeness of resection in all cases. CONCLUSION: Vascular resections in pancreatic cancer resections remain demanding procedures, and are reserved for cases in which a radical resection is feasible. Copyright
BACKGROUND/AIM: Pancreatic cancer remains asymptomatic for a long period of time, being frequently diagnosed when vascular invasion is already present. Such cases are widely known as borderline lesions. The aim of this study was to identify the effectiveness of vascular resection in this subgroup of patients. PATIENTS AND METHODS: Fifteen such cases were submitted to surgery with curative intent. RESULTS: Eight cases were diagnosed with borderline resectable lesions with portal vein invasion and were submitted to per primam resection and seven cases were initially diagnosed with arterial invasion and had been initially submitted to neoadjuvant chemotherapy followed by resection. In all cases portal vein resection was needed while in other four cases association of superior mesenteric artery resection was performed. Postoperatively, five patients developed complications requiring reoperation, three of whom died at the end of the first postoperative month. The histopathological studies confirmed the completeness of resection in all cases. CONCLUSION: Vascular resections in pancreatic cancer resections remain demanding procedures, and are reserved for cases in which a radical resection is feasible. Copyright
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