Surgery for pancreas cancer with resection of the portal vein, hepatic artery and superior mesenteric artery

Sixty two patients underwent resection of the pancreas for duct carcinoma between 1978 and 1994 (resectability 50%). Total numbers of procedures by types were 29 pancreatodudoenectomies, 26 total pancreatectomies and 7 distal pancreatectomies. The hospital mortality rate was 6.5%. Resection of the portal vein was performed in 42 of 62 cases (68%). Of these 42, further resection of the hepatic artery was done in 7, resection of the superior mesenteric artery in 8 and the celiac artery etc. in 8. The 5 year survival rate in all 62 cases was 14%, in 42 cases of resection of the portal vein 5%, in 7 cases of resection of the hepatic artery 13%, and in the superior mesenteric artery or celiac artery 0% respectively. There were more T2 cases than T3 and T4 in the group of only the portal vein resection. The survival years of the T1 cases in the group of hepatic artery resection was longer than other groups. There tended to be less nO cases in the group of superior mesenteric artery resection than other groups. In conclusion, we would expect good prognosis in small tumors even if a tumor should invade the portal vein and hepatic artery. However, resection of the superior mesenteric artery or celiac artery would be out of question under the above circumstances.