ArticleAnnals of surgery2023
Distal Pancreatectomy With En Bloc Celiac Axis Resection (DP-CAR) for Locally Advanced Pancreatic Cancer: A Safe and Effective Procedure.
Article in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed, 17 citations in OpenAlex.
- ASO Author Reflections: The Technical Importance of the Artery-First Approach with Inflow Control in DP-CAR.Annals of surgical oncology · 2026Article
- Artery-first Approach for Distal Pancreatectomy with Celiac Axis Resection.Annals of surgical oncology · 2026Article
- Article
- Impact of preoperative internal versus external biliary drainage on surgical and oncological outcomes after pancreaticoduodenectomy: a systematic review and meta-analysis.International journal of surgery (London, England) · 2026Article
- Distal and Total Pancreatectomy With En Bloc Celiac Axis Resection for Pancreatic Cancer at a High-Volume Center.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Real-world short-term outcomes after distal pancreatectomy with en bloc celiac axis resection using the National clinical database of Japan.Surgery today · 2026Article
- Comprehensive review of current management and precision medicine in pancreatic cancer.Journal of the Chinese Medical Association : JCMA · 2026Review
- Learning Curve Effect in Reducing Local Recurrence Rate After Resection of Pancreatic Cancer With Arterial Abutment: A Single-Center Retrospective Study.Annals of gastroenterological surgery · 2026Article
- Multidisciplinary multivisceral resections involving the upper digestive tract: a United Kingdom tertiary cancer centre experience.Langenbeck's archives of surgery · 2025Article
- ASO Author Reflections: To Resect, to Embolize, or to Reconstruct? Continuing Question Regarding Hepatic Artery Management During DP-CAR.Annals of surgical oncology · 2025Article
- Article
- Successful treatment for pseudoaneurysm following distal pancreatectomy with celiac axis resection without postoperative pancreatic fistula: a case report.Surgical case reports · 2024Article
- Modified Appleby: experience improves short-term results, but is it enough?Hepatobiliary surgery and nutrition · 2023Article
- Extended Distal Pancreatectomy for Cancer of the Body and Tail of the Pancreas: Analysis of Early and Late Results.Journal of clinical medicine · 2023Article
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13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine perioperative and oncologic outcomes after distal pancreatectomy with en bloc resection of the celiac axis (DP-CAR).
backgroundDP-CAR can be used in a selective group of patients to resect locally advanced pancreatic cancer involving the celiac axis or common hepatic artery without arterial reconstruction by preserving retrograde blood flow via the gastroduodenal artery to the liver and stomach.
methodsWe analyzed all consecutive patients who had undergone DP-CAR between May 2003 and April 2022 at a tertiary hospital specialized in pancreatic surgery and present one of the largest single-center studies.
resultsA total of 71 patients underwent DP-CAR. Additional venous resection (VR) of the mesenterico-portal axis was performed in 31 patients (44%) and multivisceral resection (MVR) in 42 patients (59%). Margin-free (R0) resection was achieved in 40 patients (56%). The overall 90-day mortality rate was 8.4% for the entire patient cohort. After a cumulated experience of 16 cases, the 90-day mortality dropped to 3.6% in the following 55 patients. Extended procedures with (+) additional MVR with or without (+/-) VR resulted in higher major morbidity (Clavien-Dindo ≥IIIB; standard DP-CAR: 19%; DP-CAR + MVR +/- VR: 36%) and higher 90-day mortality (standard DP-CAR: 0%; DP-CAR + MVR +/- VR: 11%). Median overall survival after DP-CAR was 28 months.
conclusionsDP-CAR is a safe and effective procedure but requires experience. Frequently, surgical resection has to be extended with MVR and VR to accomplish tumor resection, which results in promising oncologic outcomes. However, extended resections were associated with increased morbidity and mortality.
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