Summary
Background. It is widely believed that using the “tunneling” procedure during pancreatoduodenectomy is a safe maneuver because the anterior tributaries of the portal vein (PV) are absent or very rare.
Methods. The head of the pancreas with the duodenum and the common bile duct (CBD) was obtained from 22 autopsy cases. Three colors of silicon-polymerase dyes were injected into the pancreatic artery, PV, and bile duct. The tributaries of the PV at the superior margin of the pancreas were studied.
Results. There was no anterior branch of the intrapancreatic PV. The anterior superior pancreaticoduodenal vein (ASPDV) gave a definite branch to the anterior aspect of the PV at the superior margin of the pancreas in 4 of 22 cases. When the posterior superior pancreaticoduodenal vein (PSPDV) was located in front of the CBD (5 of 22 cases), the ASPDV and PSPDV had a thick common trunk at the right side of the PV. In these 5 cases, no individual branch from the ASPDV was found at the anterior aspect of the PV.
Conclusion. PV sometimes has a definite anterior tributary at the superior margin of the pancreas; this must be kept in mind to perform the tunneling procedure during pancreatic surgery.
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References
Birtwisle Y, Ferrari C, Bourgeon A, et al. Venous drainage of the pancreas and its relations to pancreatic phlebography. Anat Clin 1983; 5: 103–113.
Chassin JL. Operative Strategy in General Surgery. An Expositive Atlas, vol 2. New York, NY, Springer-Verlag, 1980.
Douglass BE, Baggenstoss AH, Hollinshead WH. The anatomy of the portal vein and its tributaries. Surg Gynecol Obstet 1950; 91: 562–576.
Falconer CW, Griffiths E. The anatomy of the blood-vessels in the region of the pancreas. Br J Surg 1950; 37: 334–344.
Skandalakis LJ, Rowe JS Jr, Gray SW, Skandalakis JE. Surgical embryology and anatomy of the pancreas. Surg Clin North Am 1993; 73: 661–697.
Trede M, Carter DC. Surgery of the Pancreas, vol 2. Churchill Livingstone, New York, 1997.
Goseki N, Takamatsu S, Kato S, et al. An approach to the hepatic hilus with marked fibrosis: a surgical technique for reconstruction of the bile duct with a benign stricture. Surg Today 1994; 24: 876–881.
Hiatt JR, Gabbay J, Busuttil RW. Surgical anatomy of the hepatic arteries in 1000 cases. Ann Surg 1994; 220: 50–52.
Takamuro T, Oikawa I, Murakami G, Hirata K. Venous drainage from the posterior aspect of the pancreatic head and duodenum. Okajimas Folia Anat Jpn 1998; 75: 1–8.
Mourad N, Zhng J, Rath AM, Chevrel JP. The venous drainage of the pancreas. Surg Radiol Anat 1994; 16: 37–45.
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Sakamoto, Y., Nagai, M., Tanaka, N. et al. Anterior tributaries of the portal vein at the superior margin of the pancreas. International Journal of Pancreatology 28, 77–80 (2000). https://doi.org/10.1385/IJGC:28:1:77
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DOI: https://doi.org/10.1385/IJGC:28:1:77