Redirecting venous flow from the superior mesenteric vein to the inferior mesenteric vein in resections for locally advanced pancreatic cancer.

IF 1.8 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-08-29 DOI:10.1007/s00423-025-03818-1

S K Burgdorf, M Pai, N H Habib, J H Storkholm

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Abstract

Objective: To evaluate the outcome of ligation of the superior mesenteric vein (SMV) and redirection the venous flow through the inferior mesenteric vein (IMV) in selected patients with pancreatic cancer.

Background: Radical surgery is the only potentially curable treatment of pancreatic cancer. Tumor-invasion of the SMV and its attributes will in some cases make it impossible to reconstruct the venous flow.

Methods: Consecutive patients with pancreatic cancer operated between January 2019 and December 2022 were included. Selected patients eligible for venous flow reversal after systemic chemotherapy were offered surgical exploration.

Results: Eleven patients were offered surgery and nine of these went through radical resection with redirection of the venous flow through the IMV. True histological R0 resection was achieved in 6 (67%) patients. No 30- nor 90-days mortality was recorded. Median overall survival was 23.2 ± 11.5 months.

Conclusion: Redirecting venous flow through the IMV while sacrificing the SMV during pancreatic resection is a safe procedure and may provide the opportunity for curative resection in otherwise unresectable patients.

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局部晚期胰腺癌切除术中静脉从肠系膜上静脉流向肠系膜下静脉的重定向。

目的：评价选择胰腺癌患者行肠系膜上静脉（SMV）结扎术及经肠系膜下静脉（IMV）重定向的效果。背景：根治性手术是胰腺癌唯一可能治愈的治疗方法。肿瘤侵袭的SMV及其属性在某些情况下会使静脉血流无法重建。方法：纳入2019年1月至2022年12月连续手术的胰腺癌患者。选择适合全身化疗后静脉血流逆转的患者进行手术探查。结果：11例患者接受手术治疗，其中9例通过IMV进行根治性切除，静脉血流重定向。6例（67%）患者实现了真正的组织学R0切除。没有30天和90天的死亡率记录。中位总生存期为23.2±11.5个月。结论：在胰腺切除术中，在牺牲SMV的同时通过IMV重定向静脉流动是一种安全的手术方法，可能为无法切除的患者提供治疗性切除的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.