ArticleJournal of gastrointestinal oncology2019
What to expect with major vascular reconstruction during Whipple procedures: a single institution experience and literature review.
Article in Journal of gastrointestinal oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Analysis of Hepatic Artery Reconstruction in Advanced Pancreatic Head Cancer.Plastic and reconstructive surgery. Global open · 2026Article
- Not Just for Ligation: Repurposing the Gastroduodenal Artery as a Vascular Conduit During Pancreaticoduodenectomy.Cureus · 2026Article
- Impact of Different Surgical Approaches on Morbidity and Mortality in Patients with Borderline Resectable Pancreatic Head Carcinoma.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2024Article
- Article
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6 authors.
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Abstract
backgroundMajor vascular reconstruction during a pancreaticoduodenectomy (PD), also known as a Whipple procedure, leads to controversial postoperative outcomes compared to conventional Whipple. Discussion with the patient regarding postoperative expectations is a crucial component of holistic surgical healthcare. The aim of this study was to report our 8-year experience of Whipple procedures involving vascular reconstruction and to review relevant literature to further evaluate expectant outcomes, therefore leading to more accurate discussion.
methodsA retrospective review of patients undergoing Whipple procedures from January 2010, through December 2017 was performed. Patch, graft, and primary anastomosis during Whipple procedures were considered major vascular reconstruction. Literature on the current understanding of the outcomes associated with vascular reconstruction during Whipple procedures was reviewed.
resultsTwenty-nine from a total of 405 patients that met inclusion criteria had a Whipple procedure that involved major vascular reconstruction. Twelve patients were male and 17 were female (mean age, 65.2 years). Median hospital and intensive care unit (ICU) stay [range] of patients with vascular reconstruction was 12 [5-92] days and 3 [0-59] days, respectively. Thirty-day survival and 1-year survival of patients with vascular reconstruction was 93.1% and 55.2%, respectively, compared to non-vascular reconstruction patients 96.0% and 83.5%, respectively (P=0.35, P<0.001). Ninety-day readmission for vascular reconstruction patients was 31.0% compared to 14.6% in non-vascular reconstruction patients (P=0.03). The 1-year survival of those who had patch reconstruction, graft reconstruction, and primary anastomosis was 50.0%, 62.5%, 53.8%, respectively.
conclusionsCompared to conventional Whipple procedures, those requiring major vascular reconstruction are associated with decreased survival. When vascular reconstruction is a valid option patients should be well aware of the associated outcomes.
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