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. 2019 Jan;98(3):e14204.
doi: 10.1097/MD.0000000000014204.

Laparoscopic pancreatoduodenectomy combined with portal-superior mesenteric vein resection and reconstruction with interposition graft: Case series

Xin Wang  1 , Yunqiang Cai  2 , Wei Zhao  3 , Pan Gao  2 , Yongbin Li  2 , Xubao Liu  1 , Bing Peng  1   2
Affiliations

Laparoscopic pancreatoduodenectomy combined with portal-superior mesenteric vein resection and reconstruction with interposition graft: Case series

Xin Wang et al. Medicine (Baltimore). 2019 Jan.

Abstract

Rationale: With the development of laparoscopic techniques, laparoscopic pancreatoduodenectomy was applied in various indications including pancreatic cancer. Here, we share our experience of venous resection and reconstruction with interposition graft in laparoscopic pancreatoduodenectomy in these patients.

Patient concerns: We reviewed data of laparoscopic pancreatoduodenectomy with venous resection and reconstruction in patients with pancreatic cancer between the dates of October 2010 and November 2017.

Outcomes: Ten patients underwent laparoscopic pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction with interposition graft. The mean operative time was 547 min. The mean blood loss was 435 ml. The mean length of venous defect after resection was 5.4 cm. R0 resection was achieved in nine patients (90%). There was one patient who suffered from severe postoperative complication. There was no 30-day mortality in this study. The long-term patency was achieved in all patients.

Conclusion: In this study, we demonstrate the initial experience of laparoscopic pancreaticoduodenectomy with long venous resection and reconstruction. Although applied in small number of patients, it could be another option for well-selected patients with reasonable morbidity and mortality as well as long-term outcomes in experienced minimally invasive surgical team.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Trocar placement.
Figure 2
Figure 2
Clear tissue on the right side of SMA. CA = celiac trunk, PV = portal vein, SMA = superior mesenteric vein.
Figure 3
Figure 3
“Rotation technique” in caudal anastomosis.
Figure 4
Figure 4
“Posterior to anterior” technique in cephalic anastomosis. Left = posterior wall anastomosis, right = anterior wall anastomosis.
See this image and copyright information in PMC

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