Portal vein reconstruction during pancreaticoduodenal resection using an internal jugular vein as a graft

Abstract

Portal vein involvement by malignant tumours of the head of the pancreas is observed in almost 50% of the patients. In the past, this finding usually rendered the tumor inoperable. Over the past 30 years, the operative morbidity and mortality rate of pancreatectomy combined with portal vein resection has greatly decreased, and portal vein resection in pancreatic surgery has become a well-tolerated operative procedure in large-volume centres. Options for a venous reconstruction after SMV/PV resection include prosthetic, autologous or cryopreserved cadaveric vein grafts.Vascular resection and reconstruction provides great opportunity for R0 resection and improvement of oncological results in patients with pancreatic tumors and involvement of venous vessels, in the absence of distant metastases. If a longer graft length is required, there is the option of using either synthetic prosthesis or cryopreserved grafts. Their weak sides can be avoided by the use of jugular vein graft. Portal vein resection will be performed more often, safely and aggressively over the next years.

Keywords

• pancreaticoduodenal resection
• portal vein reconst