Patency Rates of Portal Vein/Superior Mesenteric Vein Reconstruction After Pancreatectomy for Pancreatic Cancer

A. N. Krepline, K. K. Christians, K. Duelge, A. Mahmoud, P. Ritch, B. George, B. A. Erickson, W. D. Foley, E. J. Quebbeman, K. K. Turaga, F. M. Johnston, T. C. Gamblin, D. B. Evans, S. Tsai

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Pancreatectomy with venous reconstruction (VR) for pancreatic cancer (PC) is occurring more commonly. Few studies have examined the long-term patency of the superior mesenteric-portal vein confluence following reconstruction. Methods: From 2007 to 2013, patients who underwent pancreatic resection with VR for PC were classified by type of reconstruction. Patency of VR was assessed using surveillance computed tomographic imaging obtained from date of surgery to last follow-up. Results: VR was performed in 43 patients and included the following: tangential resection with primary repair (7, 16 %) or saphenous vein patch (9, 21 %); segmental resection with splenic vein division and either primary anastomosis (10, 23 %) or internal jugular vein interposition (8, 19 %); or segmental resection with splenic vein preservation and either primary anastomosis (3, 7 %) or interposition grafting (6, 14 %). All patients were instructed to take aspirin after surgery; low molecular weight heparin was not routinely used. An occluded VR was found in four (9 %) of the 43 patients at a median follow-up of 13 months; median time to detection of thrombosis in the four patients was 72 days (range 16–238). Conclusions: Pancreatectomy with VR can be performed with high patency rates. The optimal postoperative pharmacologic therapy to prevent thrombosis requires further investigation.

Original languageEnglish (US)
Pages (from-to)2016-2025
Number of pages10
JournalJournal of Gastrointestinal Surgery
Volume18
Issue number11
DOIs
StatePublished - Nov 2014
Externally publishedYes

Keywords

  • Pancreatic cancer
  • Vein resection

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Fingerprint Dive into the research topics of 'Patency Rates of Portal Vein/Superior Mesenteric Vein Reconstruction After Pancreatectomy for Pancreatic Cancer'. Together they form a unique fingerprint.

Cite this