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The following is a summary of “Portomesenteric Venous Thrombosis after Pancreatic Cancer Surgery with Venous Resection and Reconstruction: Timing, Incidence, and Risk Factors,” published in the December 2024 issue of Surgery by Ishida et al.
Pancreatic cancer surgery with portomesenteric venous resection (PVR) can lead to portomesenteric venous thrombosis (PVT), but the long-term outcomes and risk factors are not well understood.
Researchers conducted a retrospective study to investigate the incidence and risk factors of PVT after pancreatic cancer surgery with PVR.
They included patients undergoing pancreatic resection with PVR at the University of Colorado Hospital (January 2012 and June 2023). The study period was divided based on local standardization of PVR techniques (August 2018). The incidence of PVT was categorized as early (≤30 days postoperatively) or late (>30 days postoperatively). Risk factors for late PVT were assessed using Cox regression models.
The results showed 3.3% (n=5) of patients developed early PVT. The incidence decreased from 12% (n=3/25) to 1.6% (n=2/127) after the standardization of techniques (P=0.03). Among 130 patients with postoperative imaging, 21.5% (n=28) developed late PVT at a median of 7.4 months after surgery. Late PVT was frequently diagnosed alongside local recurrence (75%) and was associated with shorter recurrence-free survival (median 9.0 months vs. 16.3 months, P=0.014). Multivariable analysis showed that neoadjuvant radiotherapy (HR, 2.19; 95% CI, 1.02-4.67) and local recurrence (HR, 5.21; 95% CI, 2.18-12.4) were associated with an increased risk of late PVT.
They concluded that early PVT after pancreatic resection with PVR was rare, while late PVT was associated with neoadjuvant radiotherapy and local recurrence.
