Reevaluation of the indications for radical pancreatectomy to treat pancreatic carcinoma: Is portal vein infiltration a contraindication?

Purpose. Portal vein resection (PVR) has become more widely performed owing to improvements in the perioperative mortality rate. The present study was performed to determine whether portal vein infiltration is a contraindication against radical pancreatectomy for patients with pancreatic carcinoma. Methods. Between 1990 and 1997, a total of 66 patients with invasive ductal carcinoma of the pancreas underwent surgical resection at the Department of Surgery 11, Hokkaido University Hospital. After the exclusion of those who underwent distal pancreatectomy, the remaining 43 patients were divided into a PVR(+) group (n = 28) and a PVR(-) group (n = 15). The clinicopathological characteristics, morbidity, and mortality were statistically compared between the two groups. Results. The overall survival rate of the patients who required PVR was not significantly different from that of those who underwent pancreatic resection without PVR. Conclusion. These findings suggest that combined PVR should not be a contraindication to radical pancreatectomy for pancreatic carcinoma with positive vascular invasion.