ĐÁNH GIÁ KẾT QUẢ SỚM PHẪU THUẬT CẮT KHỐI TÁ TỤY KÈM CẮT MẠCH MÁU LỚN TRONG UNG THƯ TỤY TẠI BỆNH VIỆN BẠCH MAI GIAI ĐOẠN 2020-2024

Abstract

Background: This study aimed to evaluate the clinical and paraclinical characteristics and early outcomes of pancreaticoduodenectomy with major vascular resection for pancreatic cancer at Bach Mai Hospital during 2020–2024.

Methods: This was a retrospective descriptive case series of 24 patients with carcinoma (pancreatic, distal common bile duct, ampulla of Vater, or duodenum) who underwent pancreaticoduodenectomy with major vascular resection at Bach Mai Hospital between October 2020 and August 2024. Data were analyzed using SPSS 22.0.

Results: The mean age was 63.54 ± 6.92 years, with a male predominance (79%). Pancreatic head tumors were most common (58.3%), and the mean tumor size was 32.29 ± 8.59 mm. All patients underwent pancreaticoduodenectomy with major vascular resection using an oncologic radical dissection strategy (total mesopancreas excision and a left-sided artery-first approach). Vascular involvement predominantly affected the venous system; venous reconstruction was performed by primary repair (54.17%) or autologous graft interposition/patch (45.83%). Arterial resection was performed selectively, using either primary repair or arterial divestment. The R0 resection rate was 87.5%, and lymph node metastasis was found in 66.67% of cases. Mean operative time was 350.63 minutes, and mean estimated blood loss was 382.73 mL. No 90-day mortality was recorded, and most postoperative complications were mild (Clavien–Dindo grade I–II).

Conclusions: Pancreaticoduodenectomy with major vascular resection and reconstruction is feasible and safe for locally invasive pancreatic cancer when appropriately indicated and performed at an experienced center, achieving a high R0 rate with acceptable early outcomes.