Clinical study of transient portal vein stenosis induced after pancreatic head resection.
OBJECTIVE
We prospectively analyzed the clinical significance of transient portal vein stenosis soon after a pancreaticoduodenectomy (PD) as detected on three-dimensional computed tomography (3D-CT) for portography.


METHODS
This study included 20 patients who underwent a generalized pancreatic head resection. A 3D-CT scan was taken seven times up until the eighth postoperative week for each patient. The 3D images were reconstructed by the Voxel Transmission method. The portal vein images were quantified using the portal volume rates (PVR). The relationship between portal vein stenosis and six clinical factors was statistically analyzed.


RESULTS
The 3D-CT scans showed portal vein stenosis in all 20 patients. The preoperative mean of these 20 PVR were 100%, and the postoperative values were 76.2%, 64.1%, 69.5%, 75.1%, 84.1%, and 89.8% at weeks 1-4, 6, and 8, respectively. Portal vein stenosis soon after PD reached a peak in the second week and almost disappeared by the eighth postoperative week. Three clinical factors, namely, the main pancreatic duct diameters, pancreatic reconstruction methods, and postoperative prognoses, significantly affected portal vein stenosis.


CONCLUSIONS
The stenotic changes to the portal vein are considered to be significant prognostic indicators of pancreatic anastomotic trouble and postoperative complications.
Yamashita
Yuki
Y
Department of Surgery, Shiseikai Second Hospital, 5-19-1 Kamisoshigaya, Setagaya-ku, Tokyo 157-8550, Japan.
Ryo
Hideki
H
Takasaki
Ken
K
D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006975:Hypertension, Portal / Q000000981:diagnostic imaging / Q000209:etiology*; D021621:Imaging, Three-Dimensional; D016014:Linear Models; D008297:Male; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods; D011169:Portal Vein / Q000000981:diagnostic imaging* / Q000473:pathology; D011172:Portography; D011182:Postoperative Care; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods