[Role of pancreatic hilar vascular occlusion in sophisticated pancreaticoduodenectomy].
OBJECTIVE
To discuss the value of a simple occlusive technique of the triple vessels, ie, portal vein, superior mesenteric vessels and splenic vein, in complicated pancreaticoduodenectomy.


METHODS
The technique was fulfilled with a No.8 urethral catheter to encycle the portal vein, superior mesenteric vessels and its near tissue plus pancreatic tail and splenic vein than the neck of pancreas was transected and well exposure superior mesenteric vein and complete transaction of uncinate. From November 2005 to November 2006 the technique was applied to 12 cases of pancreatic malignancy which presented very infiltrated and adhesive to the hilar vascular structure.


RESULTS
The 12 cases were accomplished according with this technique. The operating time was (292.4 +/- 36.3) min (270 - 390 min) and the intraoperative blood loss was (833.3 +/- 618.4) ml (300 - 2500 ml). The postoperative complication included one case of lymphatic leakage, two cases of pneumonia, one case of abdominal infection and two cases of wound infection. There was no perioperative mortality. The postoperative hospital stay was 17 d (11 - 29 d).


CONCLUSIONS
Use this triple vessels occlusive technique can improve the safety and feasibility in complicated cases of pancreaticoduodenectomy.
Peng
Shu-you
SY
Department of General Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou 310016, China.
Hong
De-fei
DF
Xu
Bin
B
Yan
Li-feng
LF
Wang
Jian-wei
JW
Liu
Ying-bin
YB
Li
Jiang-tao
JT
Qian
Hao-ran
HR
Mou
Yi-ping
YP
Cai
Xiu-jun
XJ
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000503:physiopathology; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010179:Pancreas / Q000098:blood supply / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011169:Portal Vein / Q000503:physiopathology; D013162:Splenic Vein / Q000503:physiopathology; D016896:Treatment Outcome