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. 2016 Jul;18(7):615-22.
doi: 10.1016/j.hpb.2016.05.010. Epub 2016 Jun 20.

Cold-stored cadaveric venous allograft for superior mesenteric/portal vein reconstruction during pancreatic surgery

Dyre Kleive  1 , Audun E Berstad  2 , Caroline S Verbeke  3 , Sven P Haugvik  4 , Ivar P Gladhaug  5 , Pål-Dag Line  6 , Knut J Labori  7
Affiliations

Cold-stored cadaveric venous allograft for superior mesenteric/portal vein reconstruction during pancreatic surgery

Dyre Kleive et al. HPB (Oxford). 2016 Jul.

Abstract

Background: SMV/PV resection has become common practice in pancreatic surgery. The aim of this study was to evaluate the technical feasibility and surgical outcome of using cold-stored cadaveric venous allografts (AG) for superior mesenteric vein (SMV) and portal vein (PV) reconstruction during pancreatectomy.

Methods: Patients who underwent pancreatic resection with concomitant vascular resection and reconstruction with AG between January 2006 and December 2014 were identified from our institutional prospective database. Medical records and pre- and postoperative CT-images were reviewed.

Results: Forty-five patients underwent SMV/PV reconstruction with AG interposition (n = 37) or AG patch (n = 8). The median operative time and blood loss were 488 min (IQR: 450-551) and 900 ml (IQR: 600-2000), respectively. Major morbidity (Clavien ≥ III) occurred in 16 patients. Four patients were reoperated (thrombosis n = 2, graft kinking/low flow n = 2) and in-hospital mortality occurred in two patients. On last available CT scan, 3 patients had thrombosis, all of whom also had local recurrence. Estimated cumulative patency rate (reduction in SMV/PV luminal diameter <70% and no thrombosis) at 12 months was 52%.

Conclusion: Cold-stored cadaveric venous AG for SMV/PV reconstruction during pancreatic surgery is safe and associated with acceptable long-term patency.

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Figures

Figure 1
Figure 1
Kaplan-Meyer analysis of patency rate on the study population. Patients with early and late graft failure are included in the analysis. For definitions of patency, see text
See this image and copyright information in PMC

References

    1. Liles J.S., Katz M.H. Pancreaticoduodenectomy with vascular resection for pancreatic head adenocarcinoma. Expert Rev Anticancer Ther. 2014;14:919–929. - PubMed
    1. Bockhorn M., Uzunoglu F.G., Adham M., Imrie C., Milicevic M., Sandberg A.A. Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS) Surgery. 2014;155:977–988. - PubMed
    1. Zhou Y., Zhang Z., Liu Y., Li B., Xu D. Pancreatectomy combined with superior mesenteric vein-portal vein resection for pancreatic cancer: a meta-analysis. World J Surg. 2012;36:884–891. - PubMed
    1. Carrere N., Sauvanet A., Goere D., Kianmanesh R., Vullierme M.P., Couvelard A. Pancreaticoduodenectomy with mesentericoportal vein resection for adenocarcinoma of the pancreatic head. World J Surg. 2006;30:1526–1535. - PubMed
    1. Delpero J.R., Boher J.M., Sauvanet A., Le Treut Y.P., Sa-Cunha A., Mabrut J.Y. Pancreatic adenocarcinoma with venous involvement: is up-front synchronous portal-superior mesenteric vein resection still justified? A survey of the Association Francaise de Chirurgie. Ann Surg Oncol. 2015;22:1874–1883. - PubMed

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