1262 Comparison of Oncological Outcomes Following a Whipple Procedure with Vascular Resection to a Standard Whipple Procedure

Aim A Whipple procedure with vasculature resection is performed in selected patients when indicated. The oncological outcomes were reviewed and compared with patients who underwent a standard Whipple procedure. Method As part of a wider literature review, survival outcomes following a standard Whipple procedure were compared with patients who underwent either arterial or venous resection. Anatomical dissection of cadavers was also conducted to highlight the concomitant anatomy. Results When venous resection was performed there was a lower 5-year survival compared to the standard Whipple procedure. However, this difference became non-significant once subgroup analysis was performed on studies which used neo-adjuvant therapy. Effective performance of arterial resection demonstrated greater median survival over palliative care. Though, when compared to those who underwent a standard Whipple procedure the median survival, 1-year and 3-year survival was lower. Conclusions When neo-adjuvant therapy is used, the oncological outcomes of those who underwent a venous resection Whipple procedure were similar to those who underwent a standard Whipple procedure. Clinicians should be aware of the possible benefits this provides in increasing survival. The Whipple procedure with arterial resection is a possible treatment as it demonstrated greater oncological outcomes over palliative care. However, these patients need to be carefully selected by the surgeon.