Abstract
Vascular resection during surgery for adenocarcinoma of the pancreas is being performed with increasing frequency in order to achieve an R0 resection. With increasingly radical operations come challenges for reconstruction. Generally, these are related to reconstruction of the portal vein; this is particularly true of long-segment vein involvement by the tumor, in which venous outflow from dependent organs can become compromised. We report the first case of left gastric vein to inferior mesenteric vein bypass during a radical total pancreatectomy with long-segment portal vein resection for pancreatic adenocarcinoma, performed to relieve severe gastric venous congestion.
References
Cattell RB, Braasch JW. A technique for the exposure of the third and fourth portions of the duodenum. Surg Gynecol Obstet 1960;111:378.
Bold RJ, Charnsangavej C, Cleary KR, et al. Major vascular resection as part of pancreaticoduodenectomy for cancer: radiologic, intraoperative, and pathologic analysis. J Gastrointest Surg 1999;3(3):233.
Christians K, Evans DB. Pancreaticoduodenectomy and vascular resection: persistent controversy and current recommendations. Ann Surg Oncol 2009;16(4):789.
Evans DB, Farnell MB, Lillemoe KD, Vollmer C, Jr., Strasberg SM, Schulick RD. Surgical treatment of resectable and borderline resectable pancreas cancer: expert consensus statement. Ann Surg Oncol 2009; 16(7):1736.
Sugiura M, Futagawa S. Results of six hundred thirty-six esophageal transections with paraesophagogastric devascularization in the treatment of esophageal varices. J Vasc Surg 1984;1(2):254.
Kambayashi J, Kawasaki T, Uemura Y, Mori T. Appraisal of the use of an externally supported polytetrafluoroethylene graft in left gastric vein to inferior vena cava shunting. Eur J Surg 1994; 160(12):675.
Lacerda CM, de Melo PS, Amorim A, Carvalho G, Pereira LB. The left gastric vein as an alternative to portal reconstruction in orthotopic liver transplantation. Transplant Proc 2002;34(4):1216.
Okuda K, Nakashima T, Okudaira M, et al. Anatomical basis of hepatic venographic alterations in idiopathic portal hypertension. Liver 1981;1(4):255.
Query JA, Sandler AD, Sharp WJ. Use of autogenous saphenous vein as a conduit for mesenterico-left portal vein bypass. J Pediatr Surg 2007;42(6):1137.
Krebs-Schmitt D, Briem-Richter A, Grabhorn E, et al. Effectiveness of Rex shunt in children with portal hypertension following liver transplantation or with primary portal hypertension. Pediatr Transplant 2009;13(5):540.
Waddell WG, Moonje V, Peixoto RS, Bourdeau R, Smith G. Technical problems in direct left gastric vein diversion. Br J Surg 1970;57(11):856.
Kurosaki I, Hatakeyama K. Preservation of the left gastric vein in delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy. J Gastrointest Surg 2005;9(6):846.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sandroussi, C., McGilvray, I.D. Gastric Venous Reconstruction After Radical Pancreatic Surgery: Case Report and Review of the Literature. J Gastrointest Surg 14, 1027–1030 (2010). https://doi.org/10.1007/s11605-010-1192-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11605-010-1192-0