AB089. P061. Pancreatectomies associated to vein resection: a large single institution experience

Background: Potential benefits of pancreatectomies associated to vein resection (PAVR) are still contradictory in literature. This study aims to analyze short and long term outcomes of PAVR.

Methods: A retrospective analysis of a consecutive series of patients underwent PAVR from 2008 to 2017 was performed.

Results: Of 258 patients underwent PAVR at Karolinska University Hospital, 194 with histologically proved PDAC were included. Severe post-operative complications were observed in 10.3%, and required reoperation in 7.7% of cases. Mortality was 2.6% and the median post-operative stay was 14 days. No differences in post-operative complication rates were observed comparing different surgical techniques. Patients with ASA score ≥3 experienced more surgical complications (27.2% vs. 13.8%; P=0.02). In multivariate analysis ASA score ≥3 and multivisceral resections were predictive factors for complications. The 1, 3 and 5 years survival rates were 64%, 21% and 12.6% respectively. The median survival of patients underwent lone vein resection was superior to patients underwent combined artery-vein resection (17 vs. 10 months; P=0.02). Patients who received adjuvant chemotherapy had also a longer median survival (23 vs. 12 months; P=0.0005) as well as patients with pre-operative levels of serum Ca 19-9 ≤200 U/mL (23 vs. 15 months; P=0.01).

Conclusions: PAVR are safe and feasible. The selection criteria for resection play a key role in the outcome. Post-operative chemotherapy is confirmed as one of the most important prognostic factors. Pre-operative levels of Ca 19-9 could maybe be used for selecting good candidates for neo-adjuvant treatment.