Pancreaticoduodenectomy in the presence of superior mesenteric venous obstruction

Leonidas Koniaris, Kevin F. Staveley-O'Carroll, Herbert J. Zeh, Eduardo Perez, Xiao Ling Jin, Warren R. Maley, Gazi Zabari, David L. Bartlett, Amit Khanna, Dido Franceschi, Luke O. Schoeniger

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

The study goal was to determine the technical feasibility and outcomes associated with pancreaticoduodenectomy for periampullary malignancies with near (>80%) or complete (100%) superior mesenteric venous (SMV) obstruction. A retrospective examination of 11 patients with high-grade or complete SMV obstruction who underwent pancreaticoduodenectomy at five academic medical centers is reviewed. Pancreaticoduodenectomy for locally advanced periampullary malignancies causing high-grade or complete SMV obstruction is technically feasible. Operative approaches and outcomes are presented. One 30-day death was observed. Median survival of the cohort is 18 months. Survivals exceeding 2 years post-resection have been observed. In a number of cases, significant palliation of pain and of biliary and duodenal obstruction were achieved. Based on this initial series, pancreaticoduodenectomy in the presence of near or total SMV obstruction is feasible, may result in an R0 resection, and may be beneficial in select patients with a periampullary malignancy. We suggest such an approach be considered particularly following completion of neoadjuvant therapy without systemic progression. Further studies and more long-term follow-up at high-volume centers are required, however, to better determine the indications and potential benefit of such an undertaking.

Original languageEnglish (US)
Pages (from-to)915-921
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume9
Issue number7
DOIs
StatePublished - Sep 2005
Externally publishedYes

Fingerprint

Pancreaticoduodenectomy
Duodenal Obstruction
Neoplasms
Neoadjuvant Therapy
Survival
Pain

Keywords

  • Cancer
  • Neoadjuvant
  • Pancreatic
  • Pancreatitis
  • Technique
  • Whipple

ASJC Scopus subject areas

  • Surgery

Cite this

Koniaris, L., Staveley-O'Carroll, K. F., Zeh, H. J., Perez, E., Jin, X. L., Maley, W. R., ... Schoeniger, L. O. (2005). Pancreaticoduodenectomy in the presence of superior mesenteric venous obstruction. Journal of Gastrointestinal Surgery, 9(7), 915-921. https://doi.org/10.1016/j.gassur.2005.04.005

Pancreaticoduodenectomy in the presence of superior mesenteric venous obstruction. / Koniaris, Leonidas; Staveley-O'Carroll, Kevin F.; Zeh, Herbert J.; Perez, Eduardo; Jin, Xiao Ling; Maley, Warren R.; Zabari, Gazi; Bartlett, David L.; Khanna, Amit; Franceschi, Dido; Schoeniger, Luke O.

In: Journal of Gastrointestinal Surgery, Vol. 9, No. 7, 09.2005, p. 915-921.

Research output: Contribution to journalArticle

Koniaris, L, Staveley-O'Carroll, KF, Zeh, HJ, Perez, E, Jin, XL, Maley, WR, Zabari, G, Bartlett, DL, Khanna, A, Franceschi, D & Schoeniger, LO 2005, 'Pancreaticoduodenectomy in the presence of superior mesenteric venous obstruction', Journal of Gastrointestinal Surgery, vol. 9, no. 7, pp. 915-921. https://doi.org/10.1016/j.gassur.2005.04.005
Koniaris, Leonidas ; Staveley-O'Carroll, Kevin F. ; Zeh, Herbert J. ; Perez, Eduardo ; Jin, Xiao Ling ; Maley, Warren R. ; Zabari, Gazi ; Bartlett, David L. ; Khanna, Amit ; Franceschi, Dido ; Schoeniger, Luke O. / Pancreaticoduodenectomy in the presence of superior mesenteric venous obstruction. In: Journal of Gastrointestinal Surgery. 2005 ; Vol. 9, No. 7. pp. 915-921.
@article{e1b90f61dc9e4a608a4296355f929c81,
title = "Pancreaticoduodenectomy in the presence of superior mesenteric venous obstruction",
abstract = "The study goal was to determine the technical feasibility and outcomes associated with pancreaticoduodenectomy for periampullary malignancies with near (>80{\%}) or complete (100{\%}) superior mesenteric venous (SMV) obstruction. A retrospective examination of 11 patients with high-grade or complete SMV obstruction who underwent pancreaticoduodenectomy at five academic medical centers is reviewed. Pancreaticoduodenectomy for locally advanced periampullary malignancies causing high-grade or complete SMV obstruction is technically feasible. Operative approaches and outcomes are presented. One 30-day death was observed. Median survival of the cohort is 18 months. Survivals exceeding 2 years post-resection have been observed. In a number of cases, significant palliation of pain and of biliary and duodenal obstruction were achieved. Based on this initial series, pancreaticoduodenectomy in the presence of near or total SMV obstruction is feasible, may result in an R0 resection, and may be beneficial in select patients with a periampullary malignancy. We suggest such an approach be considered particularly following completion of neoadjuvant therapy without systemic progression. Further studies and more long-term follow-up at high-volume centers are required, however, to better determine the indications and potential benefit of such an undertaking.",
keywords = "Cancer, Neoadjuvant, Pancreatic, Pancreatitis, Technique, Whipple",
author = "Leonidas Koniaris and Staveley-O'Carroll, {Kevin F.} and Zeh, {Herbert J.} and Eduardo Perez and Jin, {Xiao Ling} and Maley, {Warren R.} and Gazi Zabari and Bartlett, {David L.} and Amit Khanna and Dido Franceschi and Schoeniger, {Luke O.}",
year = "2005",
month = "9",
doi = "10.1016/j.gassur.2005.04.005",
language = "English (US)",
volume = "9",
pages = "915--921",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
publisher = "Springer New York",
number = "7",

}

TY - JOUR

T1 - Pancreaticoduodenectomy in the presence of superior mesenteric venous obstruction

AU - Koniaris, Leonidas

AU - Staveley-O'Carroll, Kevin F.

AU - Zeh, Herbert J.

AU - Perez, Eduardo

AU - Jin, Xiao Ling

AU - Maley, Warren R.

AU - Zabari, Gazi

AU - Bartlett, David L.

AU - Khanna, Amit

AU - Franceschi, Dido

AU - Schoeniger, Luke O.

PY - 2005/9

Y1 - 2005/9

N2 - The study goal was to determine the technical feasibility and outcomes associated with pancreaticoduodenectomy for periampullary malignancies with near (>80%) or complete (100%) superior mesenteric venous (SMV) obstruction. A retrospective examination of 11 patients with high-grade or complete SMV obstruction who underwent pancreaticoduodenectomy at five academic medical centers is reviewed. Pancreaticoduodenectomy for locally advanced periampullary malignancies causing high-grade or complete SMV obstruction is technically feasible. Operative approaches and outcomes are presented. One 30-day death was observed. Median survival of the cohort is 18 months. Survivals exceeding 2 years post-resection have been observed. In a number of cases, significant palliation of pain and of biliary and duodenal obstruction were achieved. Based on this initial series, pancreaticoduodenectomy in the presence of near or total SMV obstruction is feasible, may result in an R0 resection, and may be beneficial in select patients with a periampullary malignancy. We suggest such an approach be considered particularly following completion of neoadjuvant therapy without systemic progression. Further studies and more long-term follow-up at high-volume centers are required, however, to better determine the indications and potential benefit of such an undertaking.

AB - The study goal was to determine the technical feasibility and outcomes associated with pancreaticoduodenectomy for periampullary malignancies with near (>80%) or complete (100%) superior mesenteric venous (SMV) obstruction. A retrospective examination of 11 patients with high-grade or complete SMV obstruction who underwent pancreaticoduodenectomy at five academic medical centers is reviewed. Pancreaticoduodenectomy for locally advanced periampullary malignancies causing high-grade or complete SMV obstruction is technically feasible. Operative approaches and outcomes are presented. One 30-day death was observed. Median survival of the cohort is 18 months. Survivals exceeding 2 years post-resection have been observed. In a number of cases, significant palliation of pain and of biliary and duodenal obstruction were achieved. Based on this initial series, pancreaticoduodenectomy in the presence of near or total SMV obstruction is feasible, may result in an R0 resection, and may be beneficial in select patients with a periampullary malignancy. We suggest such an approach be considered particularly following completion of neoadjuvant therapy without systemic progression. Further studies and more long-term follow-up at high-volume centers are required, however, to better determine the indications and potential benefit of such an undertaking.

KW - Cancer

KW - Neoadjuvant

KW - Pancreatic

KW - Pancreatitis

KW - Technique

KW - Whipple

UR - http://www.scopus.com/inward/record.url?scp=24044521332&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=24044521332&partnerID=8YFLogxK

U2 - 10.1016/j.gassur.2005.04.005

DO - 10.1016/j.gassur.2005.04.005

M3 - Article

C2 - 16137584

AN - SCOPUS:24044521332

VL - 9

SP - 915

EP - 921

JO - Journal of Gastrointestinal Surgery

JF - Journal of Gastrointestinal Surgery

SN - 1091-255X

IS - 7

ER -