Survival and patency outcomes in a 10-year experience of cephalic pancreatectomy associated with portomesenteric venous reconstruction.

Objective: The aim of this study is to evaluate the survival rate of patients submitted to pancreatectomies with reconstruction of the portomesenteric venous segment. Additionally, the patency rates of these venous revascularizations will be analyzed.

Design: A 10-year longitudinal study was performed.

Methods: Sixty-seven patients submitted to pancreatectomies with vascular reconstructions between January 2008 and December 2018 were retrospectively analyzed. Thirty-eight out of the 67 patients met the inclusion criteria and were included in our study.

Results: Patients had a mean survival rate of 41.5 months. The overall survival after 1 year was 75.3% and after 5 years 21.7%. Thirty days after surgery all venous reconstructions were found to be patent. The overall late patency rate among all types of venous reconstructions was 80.5%. Patients who developed thrombosis of the venous revascularization presented a tendency of lower survival.

Conclusion: Pancreatectomy associated with vascular resection is an attempt to achieve cure or increased survival of patients with advanced pancreatic cancer. Primary repair, autologous vein grafts and synthetic vein grafts are feasible techniques for venous reconstructions of the portomesenteric segment in this setting. Reconstructions using prosthetic grafts have lower patency rates than other forms of venous reconstructions.