Paediatric Surgery (Ukraine). 2025. 1(86): 53-58. doi: 10.15574/PS.2025.1(86).5358
Kvasivka O. O.¹, Pareniuk R. Y.¹, Moiseienko A. B.¹, Pepenin I. O.¹, Zemskov S. V.², Kopchak K. V.^1
1National Cancer Institute, Kyiv, Ukraine
²Bogomolets National Medical University, Kyiv, Ukraine

For citation: Kvasivka OO, Pareniuk RY, Moiseienko AB, Pepenin IO, Zemskov SV, Kopchak KV. (2025). Pancreaticoduodenal resection with venous resection: experience of a high-profile center in Ukraine. Paediatric Surgery (Ukraine). 1(86): 53-58. doi: 10.15574/PS.2025.1(86).5358.
Article received: Dec 18, 2024. Accepted for publication: Mar 18, 2025.

Aim – to evaluate the feasibility and safety of venous resections (VR) during pancreatoduodenectomy (PD) in patients with malignant tumors of the periampullary region.
Materials and methods. A retrospective cohort study was conducted, including 111 patients who underwent PD for malignant tumors of the periampullary region between 2018 and 2023. Patients were divided into two groups: with and without VR. Statistical analysis was performed to compare mean values and assess postoperative complications using the Clavien-Dindo classification.
Results. Mean blood loss, operative time, rates of complications, delayed gastric emptying, postoperative pancreatic fistula, hospital and 30-day mortality did not differ significantly between the groups. Median overall survival was 22 months in the VR group and 37 months in the non-VR group; the 5-year survival rates were 22.2% and 35.9%, respectively.
Conclusions. PD with VR is a safe and feasible procedure for patients with tumor invasion of major veins. The inclusion of VR does not significantly increase risks or worsen postoperative outcomes.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee for all participants. The informed consent of the patients was obtained for the study.
The authors declare no conflict of interest.
Keywords: pancreaticoduodenectomy, venous resection, postoperative complications, survival, adenocarcinoma, surgical procedures, pancreatic resection, pancreatic ductal adenocarcinoma, superior mesenteric vein, portal vein, morbidity.
REFERENCES

1. Bockhorn, M, Uzunoglu FG, Adham M, Imrie C, Milicevic M, Sandberg AA et al. (2014). Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery. 155(6): 977-988. https://doi.org/10.1016/j.surg.2014.02.001; PMid:24856119

2. Brunner M, Krautz C, Maak M, Weber GF, Grützmann R. (2022). Pylorus-Preserving Pancreaticoduodenectomy (PPPD) with Segmental Portal Vein Resection. Zentralblatt fur Chirurgie. 147(3): 233-241. https://doi.org/10.1055/a-1528-7927; PMid:34318466

3. Filho JELP, Marque SSB, Henriques AC, Dias AR, Waisberg J, Tustumi F. (2023). Pancreatoduodenectomy with Venous Resection or Palliative Therapy? A Meta-Analysis. Journal of the College of Physicians and Surgeons – Pakistan : JCPSP. 33(12): 1426-1432. https://doi.org/10.29271/jcpsp.2023.12.1426; PMid:38062601

4. Franko J, Hugec V, Lopes TL, Goldman CD. (2013). Survival among pancreaticoduodenectomy patients treated for pancreatic head cancer <1 or 2 cm. Annals of surgical oncology. 20(2): 357-361. https://doi.org/10.1245/s10434-012-2621-y; PMid:22941171

5. Giovinazzo F, Turri G, Katz MH, Heaton N, Ahmed I. (2016). Meta-analysis of benefits of portal-superior mesenteric vein resection in pancreatic resection for ductal adenocarcinoma. The British journal of surgery. 103(3): 179-191. https://doi.org/10.1002/bjs.9969; PMid:26663252

6. Groen JV, Michiels N, van Roessel S, Besselink MG, Bosscha K, Busch OR et al. (2021). Venous wedge and segment resection during pancreatoduodenectomy for pancreatic cancer: impact on short- and long-term outcomes in a nationwide cohort analysis. The British journal of surgery. 109(1): 96-104. https://doi.org/10.1093/bjs/znab345; PMid:34791069 PMCid:PMC10364765

7. Mohammed S, Mendez-Reyes JE, McElhany A, Gonzales-Luna D, Van Buren G, Bland DS et al. (2018). Venous thrombosis following pancreaticoduodenectomy with venous resection. The Journal of surgical research. 228: 271-280. https://doi.org/10.1016/j.jss.2018.02.006; PMid:29907222

8. Nagakawa Y, Jang JY, Kawai M, Kim SC, Inoue Y, Matsuyama R et al. (2023). Surgical Outcomes of Pancreatectomy with Resection of the Portal Vein and/or Superior Mesenteric Vein and Jejunal Vein for Pancreatic Head Cancer: A Multicenter Study. Annals of surgery. 277(5): e1081-e1088. https://doi.org/10.1097/SLA.0000000000005330; PMid:34913900

9. Peng C, Zhou D, Meng L, Cao Y, Zhang H et al. (2019). The value of combined vein resection in pancreaticoduodenectomy for pancreatic head carcinoma: a meta-analysis. BMC surgery. 19(1): 84. https://doi.org/10.1186/s12893-019-0540-6; PMid:31286916 PMCid:PMC6615269

10. Serenari M, Ercolani G, Cucchetti A, Zanello M, Prosperi E, Fallani G et al. (2019). The impact of extent of pancreatic and venous resection on survival for patients with pancreatic cancer. Hepatobiliary & pancreatic diseases international : HBPD INT. 18(4): 389-394. https://doi.org/10.1016/j.hbpd.2019.06.004; PMid:31230959

11. Vuorela T, Vikatmaa P, Kokkola A, Mustonen H, Salmiheimo A, Eurola A et al. (2022). Long Term Results of Pancreatectomy With and Without Venous Resection: A Comparison of Safety and Complications of Spiral Graft, End-to-End and Tangential/Patch Reconstruction Techniques. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 64(2-3): 244-253. https://doi.org/10.1016/j.ejvs.2022.04.006; PMid:35462018

12. Zhou GW, Wu WD, Xiao WD, Li HW, Peng CH. (2005). Pancreatectomy combined with superior mesenteric-portal vein resection: report of 32 cases. Hepatobiliary & pancreatic diseases international : HBPD INT. 4(1): 130-134.

13. Zwart ES, Yilmaz BS, Halimi A, Ahola R, Kurlinkus B et al. (2022). Venous resection for pancreatic cancer, a safe and feasible option? A systematic review and meta-analysis. Pancreatology : official journal of the International Association of Pancreatology (IAP). 22(6): 803-809. https://doi.org/10.1016/j.pan.2022.05.001; PMid:35697587