Mono-bloc total spleno-pancreaticoduodenectomy for pancreatic head carcinoma with portal-mesenteric venous invasion. A prospective randomized study

N. J. Lygidakis, Gurusharan Singh, E. Bardaxoglou, G. Dedemadi, G. Sgourakis, J. Nestoridis, A. Malliotakis, M. Pedonomou, E. K. Solomou, M. Safioleas, Maria Alamani, L. Grigorakos, E. M. Merikas

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Abstract

Background/Aims: To evaluate, the early and long-term results of mono-bloc spleno-pancreatic and vascular resection for advanced carcinoma of the head of the pancreas, with portal-mesenteric venous invasion. Methodology: In a prospective, randomized trial, fifty-six patients with advanced carcinoma of the head of the pancreas with vascular invasion were studied. Patients were randomly divided in two groups A and B. Group A patients underwent an enbloc spleno-pancreatic and vascular resection. Group B patients underwent a palliative gastro-biliary bypass. Patients in both groups were subjected to adjuvant locoregional chemoimmunotherapy, through an arterial catheter introduced into the superior mesenteric artery via a jejunal arterial branch. Results: The 2- and 5-year survival rates for Group A patients were 81.8% and 18.5%. The respective percentages for disease-free survival were 60.6% and 0%. Two-year survival for group B was nil. Conclusions: Mono-bloc spleno-pancreaticoduodenectomy and regional vascular resection and reconstruction, with adjuvant locoregional chemoimmunotherapy leads to substantial prolongation of survival and optimization of quality of life.

Original languageEnglish
Pages (from-to)427-433
Number of pages7
JournalHepato-Gastroenterology
Volume51
Issue number56
Publication statusPublished - Mar 2004

Keywords

  • Mono-bloc spleno-pancreaticoduodenectomy
  • Pancreatic head carcinoma with vascular invasion

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    Lygidakis, N. J., Singh, G., Bardaxoglou, E., Dedemadi, G., Sgourakis, G., Nestoridis, J., Malliotakis, A., Pedonomou, M., Solomou, E. K., Safioleas, M., Alamani, M., Grigorakos, L., & Merikas, E. M. (2004). Mono-bloc total spleno-pancreaticoduodenectomy for pancreatic head carcinoma with portal-mesenteric venous invasion. A prospective randomized study. Hepato-Gastroenterology, 51(56), 427-433.