For a study, the researchers sought to determine the perioperative and oncologic long-term outcomes of patients with LAPC. The latter had their pancreas removed in a high-volume pancreatic surgery center. Surgery’s significance in LAPC with vascular involvement was debatable. Between January 1, 2003, and April 30, 2019, researchers looked at 385 individuals who had PAR (n=195) or PAD (n=190) of the encased artery for LAPC. There were 183 whole pancreatectomies, 113 partial pancreatoduodenectomies, 79 distal pancreatectomies, and 10 tumor recurrence resections, including 121 multivisceral resections and 171 venous resections. Resectable oligometastatic illness was found in 43 individuals (11.4%). Neoadjuvant chemotherapy was given to all 190 patients receiving PAD (100%) and 95 of the 195 patients undergoing PAR (48.7%). The R0 (negative circumferential resection margin) resection rate was 28%. The average length of stay in the hospital was 15 days (range: 3–236). The median survival time following surgery for LAPC was 20.1 months, with a 12.5% overall 5-year survival rate. The overall patient group (n=385) had an in-hospital mortality rate of 8.8%. After 2013, there was a significant reduction in in-hospital mortality to 4.8% (n=186) (P=0.005) due to increased caseload and increased skill. For experienced pancreatic surgeons, the learning curve for PAR was 15 surgeries. The outcomes show that an arterial surgical technique is effective in LAPC and has a good long-term prognosis. PAD was safe following neoadjuvant therapy. However, PAR was a technically difficult operation that necessitated a high skill level.

 

Source:journals.lww.com/annalsofsurgery/Abstract/2022/04000/Arterial_Resection_in_Pancreatic_Cancer_Surgery_.21.aspx