title: Patency rates of portal vein/superior mesenteric vein reconstruction after pancreatectomy for pancreatic cancer.
abstract: BACKGROUND
  Pancreatectomy with venous reconstruction (VR) for pancreatic cancer (PC) is occurring more commonly. Few studies have examined the long-term patency of the superior mesenteric-portal vein confluence following reconstruction.
  
  
  METHODS
  From 2007 to 2013, patients who underwent pancreatic resection with VR for PC were classified by type of reconstruction. Patency of VR was assessed using surveillance computed tomographic imaging obtained from date of surgery to last follow-up.
  
  
  RESULTS
  VR was performed in 43 patients and included the following: tangential resection with primary repair (7, 16%) or saphenous vein patch (9, 21%); segmental resection with splenic vein division and either primary anastomosis (10, 23%) or internal jugular vein interposition (8, 19%); or segmental resection with splenic vein preservation and either primary anastomosis (3, 7%) or interposition grafting (6, 14%). All patients were instructed to take aspirin after surgery; low molecular weight heparin was not routinely used. An occluded VR was found in four (9%) of the 43 patients at a median follow-up of 13 months; median time to detection of thrombosis in the four patients was 72 days (range 16-238).
  
  
  CONCLUSIONS
  Pancreatectomy with VR can be performed with high patency rates. The optimal postoperative pharmacologic therapy to prevent thrombosis requires further investigation.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, 9200 W Wisconsin Avenue, Milwaukee, WI, 53226, USA.
authors.forename: A N
authors.initials: AN
authors.lastname: Krepline
authors.forename: K K
authors.initials: KK
authors.lastname: Christians
authors.forename: K
authors.initials: K
authors.lastname: Duelge
authors.forename: A
authors.initials: A
authors.lastname: Mahmoud
authors.forename: P
authors.initials: P
authors.lastname: Ritch
authors.forename: B
authors.initials: B
authors.lastname: George
authors.forename: B A
authors.initials: BA
authors.lastname: Erickson
authors.forename: W D
authors.initials: WD
authors.lastname: Foley
authors.forename: E J
authors.initials: EJ
authors.lastname: Quebbeman
authors.forename: K K
authors.initials: KK
authors.lastname: Turaga
authors.forename: F M
authors.initials: FM
authors.lastname: Johnston
authors.forename: T C
authors.initials: TC
authors.lastname: Gamblin
authors.forename: D B
authors.initials: DB
authors.lastname: Evans
authors.forename: S
authors.initials: S
authors.lastname: Tsai
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011169:Portal Vein / Q000601:surgery*; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology*; D014656:Vascular Surgical Procedures / Q000379:methods*