{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:41:22Z","timestamp":1792222882854,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"abstract":"ABSTRACT<\/jats:title>\n \n Evaluation of arterial resection (AR) during pancreatoduodenectomy (PD) remains limited. This study compares PD with AR to PD with venous resection (VR) and no vascular resection (NVR). Patient demographics, outcomes, and changes over 5\u2009years are evaluated. In this study, NSQIP data was analyzed comparing patients undergoing PD with AR to NVR and VR. Demographics and 30\u2010day post\u2010operative outcomes were compared, and multivariable modeling evaluated factors associated with serious complications and mortality. Propensity score matched (PSM) analysis compared AR to NVR, AR to VR, and VR to NVR. We evaluated 28,083 patients with 4.1% having AR and 10.9% having VR. After demographic adjustment, both AR (1.40;\n p<\/jats:italic>\n \u2009<\u20090.001) and VR (OR 1.32;\n p<\/jats:italic>\n \u2009<\u20090.001) were independently associated with serious complications and mortality (AR: OR 2.03;\n p<\/jats:italic>\n \u2009=\u20090.002; VR: OR 1.43;\n p<\/jats:italic>\n \u2009=\u20090.043). PSM supported increased serious complications (+4.9% VR,\n p<\/jats:italic>\n \u2009<\u20090.001; +5.40% AR,\n p<\/jats:italic>\n \u2009=\u20090.008) but not mortality (+0.4% VR,\n p<\/jats:italic>\n \u2009=\u20090.323; +1.4% AR,\n p<\/jats:italic>\n \u2009=\u20090.067) compared to NVR. AR did not increase the risk of complications or mortality compared to VR following PSM. Evaluating AR\/VR from 2017 to 2021 shows consistent demographics but increasing neoadjuvant treatment (40.2%\u201348.9%;\n p<\/jats:italic>\n \u2009<\u20090.001). Length of stay has decreased (12.3\u20139.6\u2009days;\n p<\/jats:italic>\n \u2009<\u20090.001), while serious complications (19.7%\u201322.1%) and mortality (1.7%\u20133.1%) remained similar. Results demonstrate that arterial (and venous) resection during PD is independently associated with 30\u2010day serious complications compared to without vascular resection. However, absolute morbidity rates during vascular resection may be acceptable in selected patients and appear to be similar with arterial and venous resection. Future studies evaluating long\u2010term outcomes are needed.\n <\/jats:p>","DOI":"10.1002\/ijc.70795","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:04:21Z","timestamp":1792220661000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes Following Pancreatoduodenectomy With Arterial Resection: A\n NSQIP<\/scp>\n Analysis Comparing Trends in Patient Selection and Outcomes to Venous or no Vascular Resection Over 5\u2009Years"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3110-5238","authenticated-orcid":false,"given":"Kevin","family":"Verhoeff","sequence":"first","affiliation":[{"name":"Department of Surgery University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alynne Kris","family":"Ribano","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kilburn","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol\u2010Anne","family":"Moulton","sequence":"additional","affiliation":[{"name":"Department of Surgery Ajmera Transplant Centre, Toronto General Hospital, University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaya","family":"Shwaartz","sequence":"additional","affiliation":[{"name":"Department of Surgery Ajmera Transplant Centre, Toronto General Hospital, University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Reichman","sequence":"additional","affiliation":[{"name":"Department of Surgery Ajmera Transplant Centre, Toronto General Hospital, University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"McGlivray","sequence":"additional","affiliation":[{"name":"Department of Surgery Ajmera Transplant Centre, Toronto General Hospital, University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Cleary","sequence":"additional","affiliation":[{"name":"Department of Surgery Ajmera Transplant Centre, Toronto General Hospital, University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"issue":"1","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.21037\/jgo.2018.10.03","article-title":"What to Expect With Major Vascular Reconstruction During Whipple Procedures: A Single Institution Experience and Literature Review","volume":"10","author":"Jorgensen M. S.","year":"2019","journal-title":"Journal of Gastrointestinal Oncology"},{"issue":"46","key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"17448","DOI":"10.3748\/wjg.v20.i46.17448","article-title":"Pancreaticoduodenectomy With Vascular Reconstruction for Adenocarcinoma of the Pancreas With Borderline Resectability","volume":"20","author":"Cheung T. T.","year":"2014","journal-title":"World Journal of Gastroenterology"},{"issue":"2","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jamcollsurg.2018.05.001","article-title":"Indications and Perioperative Outcomes for Pancreatectomy With Arterial Resection","volume":"227","author":"Tee M. C.","year":"2018","journal-title":"Journal of the American College of Surgeons"},{"issue":"9","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1007\/s11605-007-0216-x","article-title":"Vascular Resection and Reconstruction for Pancreatic Malignancy: A Single Center Survival Study","volume":"11","author":"Al\u2010Haddad M.","year":"2007","journal-title":"Journal of Gastrointestinal Surgery"},{"issue":"5","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1245\/s10434-008-9844-y","article-title":"Survival After Pancreatectomy With Major Arterial Resection and Reconstruction","volume":"15","author":"Stitzenberg K. B.","year":"2008","journal-title":"Annals of Surgical Oncology"},{"issue":"4","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1097\/SLA.0000000000006638","article-title":"Tangential Versus Segmental Portomesenteric Venous Resection During Pancreatoduodenectomy for Pancreatic Cancer: An International Multicenter Cohort Study on Surgical and Oncological Outcome","volume":"284","author":"Stoop T.","year":"2025","journal-title":"Annals of Surgery"},{"issue":"5","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1097\/SLA.0000000000004267","article-title":"Defining Benchmark Outcomes for Pancreatoduodenectomy With Portomesenteric Venous Resection","volume":"272","author":"Raptis D.","year":"2020","journal-title":"Annals of Surgery"},{"issue":"3","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.jamcollsurg.2013.11.017","article-title":"Portal Vein Resection in Borderline Resectable Pancreatic Cancer: A United Kingdom Multicenter Study","volume":"218","author":"Ravikumar R.","year":"2014","journal-title":"Journal of the American College of Surgeons"},{"issue":"1","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1093\/bjs\/znab345","article-title":"Venous Wedge and Segment Resection During Pancreatoduodenectomy for Pancreatic Cancer: Impact on Short\u2010 and Long\u2010Term Outcomes in a Nationwide Cohort Analysis","volume":"109","author":"Groen J.","year":"2021","journal-title":"British Journal of Surgery"},{"issue":"6","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1097\/MPA.0b013e31827b2d7c","article-title":"Aggressive Surgery for Borderline Resectable Pancreatic Cancer: Evaluation of National Comprehensive Cancer Network Guidelines","volume":"42","author":"Yamada S.","year":"2013","journal-title":"Pancreas"},{"issue":"6","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1097\/SLA.0b013e31823ac299","article-title":"Arterial Resection During Pancreatectomy for Pancreatic Cancer: A Systematic Review and Meta\u2010Analysis","volume":"254","author":"Mollberg N.","year":"2011","journal-title":"Annals of Surgery"},{"issue":"5","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1097\/SLA.0000000000003010","article-title":"Pancreatectomy With Arterial Resection for Pancreatic Adenocarcinoma: How Can It be Done Safely and With Which Outcomes?: A Single Institution's Experience With 118 Patients","volume":"271","author":"Bachellier P.","year":"2020","journal-title":"Annals of Surgery"},{"issue":"2","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1097\/SLA.0000000000003284","article-title":"Factors Predicting Response, Perioperative Outcomes, and Survival Following Total Neoadjuvant Therapy for Borderline\/Locally Advanced Pancreatic Cancer","volume":"273","author":"Truty M. J.","year":"2021","journal-title":"Annals of Surgery"},{"issue":"3","key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1016\/j.hpb.2016.11.013","article-title":"Pancreatoduodenectomy With Venous or Arterial Resection: A NSQIP Propensity Score Analysis","volume":"19","author":"Beane J. D.","year":"2017","journal-title":"HPB"},{"key":"e_1_2_11_16_1","unstructured":"American College of Surgeons \u201cACS NSQIP Participant Use Data File \u201dhttps:\/\/www.facs.org\/quality\u2010programs\/data\u2010and\u2010registries\/acs\u2010nsqip\/participant\u2010use\u2010data\u2010file\/."},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"107","DOI":"10.21037\/tgh.2017.11.14","article-title":"Modifications in the International Study Group for Pancreatic Surgery (ISGPS) Definition of Postoperative Pancreatic Fistula","volume":"2","author":"Pulvirenti A.","year":"2017","journal-title":"Transl Gastroenterol Hepatol"},{"key":"e_1_2_11_18_1","unstructured":"\u201cUser Guide for the 2021 ACS NSQIP Participant Use Data File \u201d(2022) https:\/\/www.facs.org\/media\/tjcd1biq\/nsqip_puf_userguide_2021_20221102120632.pdf."},{"issue":"2","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/01.sla.0000133083.54934.ae","article-title":"Classification of Surgical Complications: A New Proposal With Evaluation in a Cohort of 6336 Patients and Results of a Survey","volume":"240","author":"Dindo D.","year":"2004","journal-title":"Annals of Surgery"},{"issue":"1","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/SLA.0b013e318296c732","article-title":"The Comprehensive Complication Index: A Novel Continuous Scale to Measure Surgical Morbidity","volume":"258","author":"Slankamenac K.","year":"2013","journal-title":"Annals of Surgery"},{"issue":"3","key":"e_1_2_11_21_1","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1159\/000530634","article-title":"Clinical Validation of the Comprehensive Complication Index in a Pancreaticoduodenectomy Cohort","volume":"64","author":"Cai Z.","year":"2023","journal-title":"European Surgical Research"},{"key":"e_1_2_11_22_1","doi-asserted-by":"crossref","first-page":"S240","DOI":"10.1016\/j.hpb.2018.06.154","article-title":"The Comprehensive Complication Index (CCI) vs. the Clavien Dindo (CD) Drading for Measuring Severity of Post\u2010Operative Complications. A Prospective Study in 1000 Patients","volume":"20","author":"Ray S.","year":"2018","journal-title":"HPB"},{"key":"e_1_2_11_23_1","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.jss.2019.06.093","article-title":"A Comparison Between the Comprehensive Complication Index and the Clavien\u2010Dindo Grading as a Measure of Postoperative Outcome in Patients Undergoing Gastrointestinal Surgery\u2014A Prospective Study","volume":"244","author":"Ray S.","year":"2019","journal-title":"Journal of Surgical Research"},{"issue":"7","key":"e_1_2_11_24_1","doi-asserted-by":"crossref","first-page":"1672","DOI":"10.1007\/s00268-012-1546-8","article-title":"Double Omental Flap Reduced Perianastomotic Collections and Relaparotomy Rates After Pancreaticoduodenectomy With Pancreaticogastrostomy","volume":"36","author":"Rosso E.","year":"2012","journal-title":"World Journal of Surgery"},{"issue":"21","key":"e_1_2_11_25_1","doi-asserted-by":"crossref","first-page":"1986","DOI":"10.1056\/NEJMoa2201171","article-title":"Tranexamic Acid in Patients Undergoing Noncardiac Surgery","volume":"386","author":"Devereaux P. J.","year":"2022","journal-title":"New England Journal of Medicine"},{"issue":"2","key":"e_1_2_11_26_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/bjs\/znac382","article-title":"Tranexamic Acid and Blood Loss in Pancreaticoduodenectomy: TAC\u2010PD Randomized Clinical Trial","volume":"110","author":"Ishii K.","year":"2023","journal-title":"British Journal of Surgery"},{"issue":"11","key":"e_1_2_11_27_1","doi-asserted-by":"crossref","first-page":"2832","DOI":"10.1245\/s10434-010-1284-9","article-title":"Defining Venous Involvement in Borderline Resectable Pancreatic Cancer","volume":"17","author":"Chun Y. S.","year":"2010","journal-title":"Annals of Surgical Oncology"},{"issue":"2","key":"e_1_2_11_28_1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/SLA.0000000000002753","article-title":"Survival in Locally Advanced Pancreatic Cancer After Neoadjuvant Therapy and Surgical Resection","volume":"270","author":"Gemenetzis G.","year":"2019","journal-title":"Annals of Surgery"},{"issue":"6","key":"e_1_2_11_29_1","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1245\/s10434-018-07131-8","article-title":"Clinical Impact of Neoadjuvant Chemotherapy and Chemoradiotherapy in Borderline Resectable Pancreatic Cancer: Analysis of 884 Patients at Facilities Specializing in Pancreatic Surgery","volume":"26","author":"Nagakawa Y.","year":"2019","journal-title":"Annals of Surgical Oncology"}],"container-title":["International Journal of Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70795","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ijc.70795","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ijc.70795","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T07:04:25Z","timestamp":1792220665000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ijc.70795"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,17]]},"references-count":28,"alternative-id":["10.1002\/ijc.70795"],"URL":"https:\/\/doi.org\/10.1002\/ijc.70795","archive":["Portico"],"relation":{},"ISSN":["0020-7136","1097-0215"],"issn-type":[{"value":"0020-7136","type":"print"},{"value":"1097-0215","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,17]]},"assertion":[{"value":"2026-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ijc.70795"}}