Analysis of anatomic variants of mesenteric veins by 3-dimensional portography using multidetector-row computed tomography.
BACKGROUND
It is important to be aware of mesenteric venous variants to perform peripancreatic surgery. We investigated the usefulness of 3-dimensional (3-D) portography.


METHODS
Vessels were reconstructed using computer software in 102 patients undergoing multidetector-row computed tomography (MDCT) scheduled for gastrointestinal or hepatobiliary-pancreatic surgery.


RESULTS
The superior mesenteric vein (SMV) was composed of single and double trunks around the splenoportal confluence in 78 and 24 patients, respectively. The inferior mesenteric vein joined the splenic vein (68.5%), SMV (18.5%), and splenoportal confluence (7.6%). The left gastric vein joined the splenic vein (46.3%), portal vein (39.0%), and splenoportal confluence (14.7%). Seventy-nine patients showed a gastrocolic trunk, mostly composed of the right gastroepiploic vein and veins from the colonic hepatic flexure. Intraoperative findings were identical to 3-D diagnosis in 68 gastrectomized and 9 pancreatectomized patients.


CONCLUSIONS
Although mesenteric venous tributaries are complex, 3-D portography is helpful for surgeons to safely perform peripancreatic surgery.
Sakaguchi
Takanori
T
Second Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Japan. saka1119@hama-med.ac.jp
Suzuki
Shohachi
S
Morita
Yoshifumi
Y
Oishi
Kosuke
K
Suzuki
Atsushi
A
Fukumoto
Kazuhiko
K
Inaba
Keisuke
K
Kamiya
Kinji
K
Ota
Manabu
M
Setoguchi
Tomohiko
T
Takehara
Yasuo
Y
Nasu
Hatsuko
H
Nakamura
Satoshi
S
Konno
Hiroyuki
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D013505:Digestive System Surgical Procedures; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008642:Mesenteric Veins / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000601:surgery; D011172:Portography / Q000379:methods*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult