Abstract

Objective: Evaluation of surgical outcomes of Whipple procedure for the treatment of periampullary cancer with vascular invasion.

Methods: From January 2017 to May 2025, a total 33 patients underwent pancreaticoduodenectomy for treatment of periampullary cancer with vascular invasion at Hue Central Hospital.

Results: Among 33 patients who underwent Whipple procedure with segmental venous resection for the treatment of periampullary cancer, the following results were obtained: The pancreatic tissue was firm in 69,7% of cases compared to 30,3% with soft texture. The mean length of the resected vein segment was 2,7 cm (range 2–3,5 cm). Tumor invasion of the vein was classified as normal in 21,2%, unilateral narrowing in 45,5%, and bilateral narrowing in 33,3% of cases. The rate of R0 resection margin was 81,8% compared to 18,2% for R1 (p < 0.001). The mean operative time was 217 minutes (range 193–249), the mean intraoperative blood loss of 350 ml (range 342–750 ml). Overall postoperative complication rate was 21.2%. The mean time to recurrence was 27 months (range 23–52) and the mean overall survival was 33 months (range 30–62).

Conclusion: Periampullary cancer with vascular invasion is associated with a poor prognosis. However, vascular involvement in periampullary cancer is not a contraindication to curative resection. Surgical outcomes have gradually improved in recent years. The treatment for patients in periampullary cancer with vascular invasion should be delivered through a multidisciplinary approach.