title: Use of cold-stored vein allografts for venous reconstruction during pancreaticoduodenectomy.
abstract: BACKGROUND
  Venous resections and reconstructions of portal vein and/or superior mesenteric vein in course of pancreaticoduodenectomy are becoming a common practice and many surgical options have been described, from simple tangential resection and venorrhaphy to large segmental resections followed by interposition grafting. The aim of this study was to report the first experience of using fresh cadaveric vein allografts for venous reconstruction during pancreaticoduodenectomy focusing on technical feasibility and postoperative outcomes.
  
  
  METHODS
  From January 2001 to October 2012, out of 151 patients undergoing pancreaticoduodenectomy for pancreatic head tumor, 22 (14.5 %) received a vascular resection of the mesentericoportal axis. In five of these patients, vascular reconstruction was accomplished by using cold-stored venous allografts of iliac and femoral veins from donor cadaver. Patients' data, surgical techniques, and clinical outcomes were analyzed.
  
  
  RESULTS
  Five patients undergoing pancreaticoduodenectomy were selected to receive a vascular reconstruction using a fresh venous allograft for patch closure in three cases, conduit interposition in one case and a Y-shaped graft in the last case. No graft thrombosis or stenosis occurred postoperatively and at long-term follow-up. Mortality rate was zero.
  
  
  CONCLUSIONS
  The use of fresh vein allografts is a feasible and effective technique for venous reconstruction during pancreaticoduodenectomy. However, prospective surveys including large cohorts of patients are necessary to confirm these results.
authors.affiliation: Department of General Surgery and Organ Transplantation, S. Camillo Hospital, Circonvallazione Gianicolense 87, Rome, Italy.
authors.forename: Roberto L
authors.initials: RL
authors.lastname: Meniconi
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Ettorre
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vennarecci
authors.forename: Pasquale
authors.initials: P
authors.lastname: Lepiane
authors.forename: Marco
authors.initials: M
authors.lastname: Colasanti
authors.forename: Andrea
authors.initials: A
authors.lastname: Laurenzi
authors.forename: Lidia
authors.initials: L
authors.lastname: Colace
authors.forename: Roberto
authors.initials: R
authors.lastname: Santoro
mesh_terms: D000368:Aged; D064591:Allografts; D003080:Cold Temperature; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D009926:Organ Preservation / Q000379:methods*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011169:Portal Vein / Q000601:surgery*; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D014656:Vascular Surgical Procedures; D014680:Veins / Q000637:transplantation*