Portal vein resection: a modified technique for reconstruction after pancreaticoduodenectomy

Journal of Surgical Oncology
Marcel C C MachadoTelesforo Bacchella

Abstract

Pancreaticoduodenectomy is the only curative treatment for pancreatic head tumors. The possibility to achieve a potentially curative surgical treatment is limited to patients in which a complete tumor resection can be performed with free surgical margins. In a small number of patients with localized pancreatic cancer, negative margins are only accomplished with portal vein resection. Pancreaticoduodenectomy is often avoided in these patients due to the mistaken concept that venous resection may be followed by higher mortality and carries poorer survival. Actually, these patients present the same survival rate as patients similarly staged in whom portal vein resection was not performed. Therefore, venous resection is worthwhile. The authors describe an alternative technique for venous reconstruction after resection of a long segment of portal or superior mesenteric vein. The use of a venous graft as proposed in this study is feasible, easy to perform, and may simplify the venous reconstruction even in extensive mesentericoportal venous resection.

References

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Apr 18, 2001·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·T A SohnK D Lillemoe
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Citations

Jan 22, 2009·Annals of Surgical Oncology·Giovanni RamacciatoMassimo Del Gaudio
Oct 24, 2007·AJR. American Journal of Roentgenology·Chandana G LallKumaresan Sandrasegaran
Nov 5, 2008·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·M V PeriniJ E M Cunha
Jan 29, 2009·Journal of Vascular Surgery·Derek A DuBayIan McGilvray
Jun 2, 2010·Cirugía española·Francisco Ruiz GómezJoan Figueras
Jan 2, 2008·Vascular and Endovascular Surgery·Luis R LeonRobert S Krouse

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