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World J Gastrointest Surg. Mar 27, 2013; 5(3): 27-29
Published online Mar 27, 2013. doi: 10.4240/wjgs.v5.i3.27
Is there a role for arterial reconstruction in surgery for pancreatic cancer?
Reena Ravikumar, David Holroyd, Giuseppe Fusai
Reena Ravikumar, David Holroyd, Giuseppe Fusai, Department of Hepatopancreato-biliary and Liver Transplant Surgery, Royal Free London Hospital NHS Foundation Trust, London NW3 2QG, United Kingdom
Author contributions: Ravikumar R and Holroyd D reviewed the literature and wrote the paper; Fusai G reviewed the literature and revised the paper.
Correspondence to: Giuseppe Fusai, Consultant Surgeon, Department of Hepatopancreato-biliary and Liver Transplant Surgery, Royal Free London Hospital NHS Foundation Trust, Pond Street, London NW3 2QG, United Kingdom. reena.ravikumar@nhs.net
Telephone: +44-207-7940500 Fax: +44-207-8302688
Received: November 1, 2012
Revised: January 15, 2013
Accepted: January 23, 2013
Published online: March 27, 2013
Abstract

Surgery remains the only potentially curative treatment for patients with pancreatic cancer. Locally advanced pancreatic cancer with vascular involvement remains a surgical challenge because high perioperative risk and the uncertainty of a survival benefit. Whilst portal vein resection has started to gather momentum because the perioperative morbidity and long term survival is comparable to standard pancreatectomy, there isn’t yet a consensus on arterial resections. There have been various reports and case series of arterial resections in pancreatic cancer, with mixed survival results. Mollberg et al have appraised the heterogeneous published literature available on arterial resection in pancreatic cancer in an attempt to compare this to standard pancreatectomy. In this article, we discuss the results of this systematic review and meta-analysis, and the limitations associated with analysing results from heterogenous data. We have outlined the important features in surgery for pancreatic cancer and specifically to arterial resections, and compared arterial resections to the published literature on venous resections.

Keywords: Arterial resection, Pancreatic cancer, Vascular resection, Hepatic artery, Coeliac axis, Pancreatectomy