title: Double inferior vena cava does not complicate para-aortic nodal dissection for the treatment of pancreatic carcinoma.
abstract: Duplication of the inferior vena cava (IVC) involves large veins on both sides of the aorta that join anteriorly at the level of the renal arteries to become the suprarenal IVC. We report CT scan and intraoperative images of a patient with duplication of the IVC who underwent pancreaticoduodenectomy with para-aortic lymphadenectomy for carcinoma of the pancreatic head: nodal dissection along the left caval vein was not carried out. The anatomical background of the lymphatic flow to the para-aortic lymph nodes and the theoretic basis for lymph node dissection of the para-aortic area in cases of double IVC are highlighted. Lymphadenectomy along the left caval vein is not necessary in patients with double IVC who undergo pancreaticoduodenectomy with extended lymphadenectomy for carcinoma of the pancreatic head in the absence of preoperative appearance of para-aortic disease.
authors.affiliation: Department of Surgical Sciences, La Sapienza University, viale del Policlinico 155-00161 Rome, Italy. nadiapeparini@yahoo.it
authors.forename: Nadia
authors.initials: N
authors.lastname: Peparini
authors.forename: Roberto Luca
authors.initials: RL
authors.lastname: Meniconi
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Fanello
authors.forename: Piero
authors.initials: P
authors.lastname: Chirletti
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D010220:Para-Aortic Bodies / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging