Quirónsalud, pioneer in a vascular reconstruction technique to treat pancreatic cancer

Quirónsalud Málaga has become the first hospital in the province to perform a pioneering intervention using an innovative vascular reconstruction technique on a 39-year-old patient with locally advanced pancreatic cancer. This is one of the most aggressive and lethal types of tumors. The procedure was carried out by the team led by doctors César Ramírez and José Antonio Pérez Daga, surgeons from the General Surgery and Digestive System Service at the hospital.

The woman received chemotherapy treatment and successfully underwent high-complexity surgery. The novel contribution consisted of performing the vascular reconstruction of the portal vein using an autologous graft (from the patient herself) of the falciform ligament, a fibrous and elastic connective tissue that holds the liver attached to the inner wall of the abdomen, just below the diaphragm.

Avoiding rejections, the own graft optimizes postoperative recovery of patients

As César Ramírez, head of the service, points out, "being a graft from the patient herself, postoperative complications related to synthetic materials (prostheses produced by the industry) or grafts from banks, which come from other patients and can have some degree of rejection, are avoided."

In addition, it was necessary to "also remove both the entire pancreas and the stomach, as well as a segment of the portal vein, responsible for carrying all the flow from the abdomen's viscera through the liver. Since this vein is essential for life, it must be reconstructed once removed, something that is usually done with a substitute graft using a prosthesis or vascular graft from a cadaver or bank," he points out.

Doctor Ramírez, a reference in oncological surgery, states that "this case was especially complex, because, in addition to the portal vein, the patient also had the celiac artery trunk affected by the tumor, which is essential for vascularizing the liver, pancreas, and stomach. Thanks to a variant of her anatomy, it was possible to resect and this is the reason why the entire tumor could be removed."

Work of the oncologists

He also praised the work of the oncologists, who after an initial poor tolerance to the patient's chemotherapy, changed the regimen to a much more effective one that allowed this surgery to be performed.

The technique had never been performed in Málaga and represents a further step in pancreatic oncological surgery, so that the Malaga center is already a reference in high-complexity tumor intervention. At QuirónMálaga, more than 300 pancreatic cancer surgeries have been performed since 2009, including the minimally invasive technique in 20% of the cases for the last ten years.

One in three pancreatic cancer patients in Spain is diagnosed with metastasis, complicating their treatment

Pancreatic cancer will affect more than 10,300 people in Spain this year and has become the third leading cause of tumor death in the country. Approximately, one-third of the patients are diagnosed already with metastasis.

"We know that historically we are talking about a neoplasm with a poor prognosis, but the effort of the surgeons to perform an increasingly excellent technique and the support of medical oncologists with increasingly effective chemotherapy, has managed to almost double the average survival of pancreatic cancer as a disease in the last 20 years," adds Doctor Ramírez.