{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T15:57:36Z","timestamp":1780502256411,"version":"3.54.1"},"reference-count":15,"publisher":"FapUNIFESP (SciELO)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ABCD, arq. bras. cir. dig."],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:p> BACKGROUND: Due to their complexity and risks, mesenteric-portal axis resection and reconstruction during the pancreatectomy procedure were not recommended back in the early nineties. However, as per technical improvements and the reduction in morbidity and mortality rates, they have been routinely indicated in large medical centers. AIM: To show results from cases of patients subjected to mesenteric-portal axis resection during pancreatectomy. METHOD: Patients subjected to mesenteric-portal axis resection during pancreatectomy were prospectively and consecutively assessed. The procedure was indicated according to anatomical criteria defined by imaging exams or intraoperative assessment. RESULTS: Ten patients, half of them were male, with mean age of 55.7 years (40-76) were included. The most frequent underlying diseases were pancreatic adenocarcinoma and Frantz tumor. The circumferential resection of the portal vein associated with the superior mesenteric vein with splenic vein ligature (4 cases=40%) and the primary anastomosis of the vascular stumps (5 cases=50%) were, respectively, the most performed types of vascular resection and reconstruction. Surgery time ranged from 480 to 600 minutes (average=556 minutes) and postoperative hospitalization time ranged from 9 to 114 days (average=34.8 days). Morbidity rate was 60%, and clinical pancreatic fistula (grade B and C) was the most common complication (3 cases=30%). Mortality rate was 10% (1 case). CONCLUSION: Mesenteric-portal axis resection is a valid technical procedure. It should be taken into account after a clinical assessment that included not only the patients' clinical condition but also the technical and anatomical conditions of the mesenteric-portal axis tumor infiltration as well as life expectancy based on the patient's cancer prognosis.<\/jats:p>","DOI":"10.1590\/s0102-67202014000400009","type":"journal-article","created":{"date-parts":[[2015,1,24]],"date-time":"2015-01-24T15:43:26Z","timestamp":1422114206000},"page":"268-271","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes from mesenteric-portal axis resection during pancreatectomy"],"prefix":"10.1590","volume":"27","author":[{"given":"Enio Campos","family":"AMICO","sequence":"first","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte; Liga Norte-Riograndense contra o C\u00e2ncer"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Roberto","family":"ALVES","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte; Liga Norte-Riograndense contra o C\u00e2ncer"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir Assi","family":"JO\u00c3O","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Wagner da Costa","family":"MOREIRA","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Linhares da","family":"SILVA NETO","sequence":"additional","affiliation":[{"name":"Liga Norte-Riograndense contra o C\u00e2ncer"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joafran Alexandre Costa de","family":"MEDEIROS","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio Grande do Norte"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"issue":"3","key":"ref1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1590\/S0102-67202013000300011","article-title":"Complica\u00e7\u00f5es ap\u00f3s pancreatectomias: estudo prospectivo ap\u00f3s as novas classifica\u00e7\u00f5es GIEDFP e GIECP","volume":"26","author":"Amico EC","year":"2013","journal-title":"ABCD Arq Bras Cir Dig"},{"issue":"1","key":"ref2","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.surg.2005.05.001","article-title":"International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition","volume":"138","author":"Bassi C","year":"2005","journal-title":"Surgery"},{"issue":"13","key":"ref3","doi-asserted-by":"crossref","first-page":"4068","DOI":"10.1245\/s10434-012-2585-y","article-title":"The impact of vascular resection on early postoperative outcomes after pancreaticoduodenectomy: an analysis of the American College of Surgeons National Surgical Quality Improvement Program database","volume":"19","author":"Castleberry AW","year":"2012","journal-title":"Ann Surg Oncol."},{"issue":"1","key":"ref4","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1002\/cncr.26243","article-title":"Post-therapy pathologic stage and survival in patients with pancreatic ductal adenocarcinoma treated with neoadjuvant chemoradiation","volume":"118","author":"Estrella JS","year":"2012","journal-title":"Cancer"},{"issue":"2","key":"ref5","first-page":"154","article-title":"Rationale for en bloc vein resection in the treatment of pancreatic adenocarcinoma adherent to the superior mesenteric-portal vein confluence","volume":"223","author":"Fuhrman GM1","year":"1996","journal-title":"Pancreatic Tumor Study Group. Ann Surg."},{"issue":"4","key":"ref6","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s00423-014-1182-x","article-title":"Indication for the use of an interposed graft during portal vein and\/or superior mesenteric vein reconstruction in pancreatic resection based on perioperative outcomes","volume":"399","author":"Hirono S","year":"2014","journal-title":"Langenbecks Arch Surg"},{"issue":"127","key":"ref7","first-page":"1759","article-title":"Impact of portal vein invasion and resection length in pancreatoduodenectomy on the survival rate of pancreatic head cancer","volume":"60","author":"Kurihara C","year":"2013","journal-title":"Hepatogastroenterology."},{"issue":"3","key":"ref8","first-page":"550","article-title":"Radical pancreatoduodenectomy with resection and reanastomosis of the superior mesenteric vein","volume":"30","author":"Moore GE","year":"1951","journal-title":"Surgery"},{"issue":"4","key":"ref9","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1245\/s10434-008-0281-8","article-title":"Does portal-superior mesenteric vein invasion still indicate irresectability for pancreatic carcinoma","volume":"16","author":"Ramacciato G","year":"2009","journal-title":"Ann Surg Oncol"},{"issue":"8","key":"ref10","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1002\/bjs.8763","article-title":"'Artery-first' approaches to pancreatoduodenectomy","volume":"99","author":"Sanjay P","year":"2012","journal-title":"Br J Surg."},{"issue":"8","key":"ref11","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/j.gassur.2004.09.046","article-title":"Pancreaticoduodenectomy with vascular resection: margin status and survival duration","volume":"8","author":"Tseng JF","year":"2004","journal-title":"J Gastrointest Surg"},{"issue":"6","key":"ref12","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.1245\/s10434-014-3554-4","article-title":"Adverse tumor biology associated with mesenterico-portal vein resection influences survival in patients with pancreatic ductal adenocarcinoma","volume":"21","author":"Wang F","year":"2014","journal-title":"Ann Surg Oncol"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.surg.2007.05.005","article-title":"Delayed gastric emptying (DGE) after pancreatic surgery: A suggested definition by the International Study Group of Pancreatic Surgery (ISGPS)","volume":"142","author":"Wente MN","year":"2007","journal-title":"Surgery"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.surg.2007.02.001","article-title":"Postpancreatectomy hemorrhage (PPH) - An International Study Group of Pancreatic Surgery (ISGPS) definition","volume":"142","author":"Wente MN","year":"2007","journal-title":"Surgery"},{"issue":"4","key":"ref15","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ejso.2014.01.010","article-title":"Benefit from synchronous portal-superior mesenteric vein resection during pancreaticoduodenectomy for cancer: a meta-analysis","volume":"40","author":"Yu XZ","year":"2014","journal-title":"Eur J Surg Oncol"}],"container-title":["ABCD. 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