Howard Thomas J, Villanustre Nicholas, Moore Seth A, DeWitt John, LeBlanc Julia, Maglinte Dean, McHenry Lee
Pancreas Research Group and the Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA.
J Gastrointest Surg. 2003 Dec;7(8):1089-95. doi: 10.1016/j.gassur.2003.07.010.
Pancreaticoduodenectomy is often avoided in patients with portal or superior mesenteric venous involvement due to the perception that venous resection is complex, morbid, and carries a poor long-term survival. Our recent experience using state-of-the-art imaging and strict resection criteria show that venous reconstruction increases operative time, transfusion requirements, intensive care unit stay, and total hospital length of stay, but has no significant impact on operative morbidity rates, mortality rates, or the incidence of positive histologic margins. Kalpan-Meier life table analysis shows similar survival curves when compared to a contemporary cohort of patients who do not undergo venous reconstruction.
由于认为静脉切除复杂、病态且长期生存率低，门静脉或肠系膜上静脉受累的患者通常避免行胰十二指肠切除术。我们最近使用先进成像技术和严格切除标准的经验表明，静脉重建会增加手术时间、输血需求、重症监护病房停留时间和总住院时间，但对手术发病率、死亡率或组织学切缘阳性发生率没有显著影响。Kaplan-Meier生存表分析显示，与同期未进行静脉重建的患者队列相比，生存曲线相似。
