Abstracts
1999 Digestive Disease Week

# 2136 MORBIDITY AND MORTALITY AFTER PV/SMV RESECTION DURING (PP)PD
Rutger C I van Geenen, Laurens Th de Wit, Thomas M van Gulik, Hugo Obertop, Dirk J Gouma, Acad Med Ctr, Amsterdam Netherlands

Resection of the portal/superior mesenteric vein (PV/SMV)is performed during (pylorus preserving)pancreatoduodenectomies ((PP)PD)to increase resectability and in an attempt to achieve a radical resection. It has been reported that this procedure is associated with increased morbidity and mortality. The aim of this study is to investigate the influence of PV/SMV resection on morbidity, mortality and hospital stay. Between 1992 and 1998, 250 consecutive (PP)PD's were performed (morbidity 48%, mortality 1,2%). Patients with malignant disease (214/250; 86%) were further investigated. Intra operative parameters, histology, complications, hospital stay and mortality were analyzed. 34/214 (16%)patients underwent PV/SMV resection (group A) and 180 (84%) underwent standard (PP)PD (group B). In Goup A and B the median age was 65 and the gender was equaly distributed over both groups (M/F: 15/19 vs.91/89, NS) Median peroperative bloodloss in group A and B was respectively 1500 and 1000ml(p=0,002) but the median blood transfusion in both groups was 0. The median operative time group A and B was respectively 5:15 and 4:40 hours (p=0,002). Hospital mortality was respectively 0 and 1,6 (NS). Complication occurred in group A and B in respectively 32 and 52% (p=0,004) with a reoperation rate of respectively 7 and 1% (NS). The median hospital stay in both groups was respectively 14,5 and 16,5 (NS). Bloodloss and operative time are significantly higher in patients undergoing PV/VMS resection during (PP)PD. PV/SMV resection does not lead to an increased mortality, complication rate or length of hospital stay. Therefore, PV/SMV resection can be performed safely.

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