title: Optimal management of the splenic vein at the time of venous resection for pancreatic cancer: importance of the inferior mesenteric vein.
abstract: BACKGROUND
  Resection of the superior mesenteric vein (SMV)-portal vein (PV)-splenic vein (SV) confluence during pancreatectomy for pancreatic cancer requires management of the SV.
  
  
  CONCLUSIONS
  Simple SV ligation can result in sinistral portal hypertension if the inferior mesenteric vein (IMV) enters the confluence and is thereby resected, or if the IMV is insufficient to drain the SV. We describe herein three patients whose clinical course confirms the importance of the IMV decompressing the SV to avoid sinistral hypertension.
authors.affiliation: Pancreatic Cancer Program, Department of Surgery, Division of Surgical Oncology, The Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: Charles H C
authors.initials: CH
authors.lastname: Pilgrim
authors.forename: Susan
authors.initials: S
authors.lastname: Tsai
authors.forename: Parag
authors.initials: P
authors.lastname: Tolat
authors.forename: Parag
authors.initials: P
authors.lastname: Patel
authors.forename: William
authors.initials: W
authors.lastname: Rilling
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
authors.forename: Kathleen K
authors.initials: KK
authors.lastname: Christians
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology / Q000517:prevention & control*; D008026:Ligation / Q000009:adverse effects; D008297:Male; D008642:Mesenteric Veins / Q000033:anatomy & histology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011169:Portal Vein / Q000601:surgery; D013162:Splenic Vein / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery*