title: [Cephalic pancreaticoduodenectomy with mesentericoportal venous reconstruction. Technical features].
abstract: Cephalic pancreaticoduodenectomy (CPD) with mesentericoportal venous resection increases the resectability rate of pancreatic tumors. When performed in selected patients and by experienced surgical teams, this technique shows the same long-term rates of morbidity, mortality and survival as CPD without vascular resection, provided that negative surgical margins are obtained. This procedure is contraindicated by complete thrombosis of the portal or superior mesenteric veins, invasion of the superior mesenteric artery or celiac trunk, and distant or periaortic lymph node involvement. Venous reconstruction can be performed through lateral suture, termino-terminal anastomosis, or by graft placement. We believe that intercalation of the autologous internal jugular vein facilitates resection and minimizes phenomena of venous stasis. We present a case of adenocarcinoma of the pancreatic head infiltrating the superior mesenteric-portal vein confluence that underwent surgery in our hospital. CPD with mesentericoportal venous resection and reconstruction using autologous internal jugular vein were performed. The most important technical features are discussed.
authors.affiliation: Servicio de Cirugía General, Hospital de La Plana, Vila-real, Castellón, España. manzanet_ger@gva.es
authors.forename: Gerardo
authors.initials: G
authors.lastname: Manzanet
authors.forename: Consuelo
authors.initials: C
authors.lastname: Suelves
authors.forename: Asumpta
authors.initials: A
authors.lastname: Trías
authors.forename: Rogelio
authors.initials: R
authors.lastname: Calderón
authors.forename: Ramón
authors.initials: R
authors.lastname: Morón
authors.forename: Ricardo
authors.initials: R
authors.lastname: Corell
authors.forename: Jorge
authors.initials: J
authors.lastname: Navarro
authors.forename: Antonio
authors.initials: A
authors.lastname: Clarós
authors.forename: Eduardo
authors.initials: E
authors.lastname: Peiró
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Todolí
authors.forename: Lucas
authors.initials: L
authors.lastname: Castell
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods