title: Significance of the Splenic Vein and Its Branches in Pancreatoduodenectomy with Resection of the Portal Vein System.
abstract: OBJECTIVE
  Pancreatic head carcinoma frequently invades the superior mesenteric vein (SMV) and/or portal vein (PV). We aimed to evaluate the outcome of transection of the splenic vein (SV) and inferior mesenteric vein (IMV) in pancreatoduodenectomy (PD) with SMV and/or PV resection.
  
  
  METHODS
  We retrospectively analyzed the records of 660 patients who had undergone pancreatectomy at our institution from January 2004 to October 2013, and selected 141 consecutive patients who had undergone PD with concurrent SMV/PV resection. Postoperative hypersplenism and the presence of remnant branches were evaluated.
  
  
  RESULTS
  The SV had been transected in 81 patients and preserved in 60. Postoperative complications and white blood cell counts were similar between the groups. The postoperative splenic volume was not significantly associated with the status of the SV or IMV on the transected SV. The platelet count was significantly lower, and the incidence of collateral veins was higher after SV transection than after SV preservation until 6 months after surgery; these variables were similar in the long term.
  
  
  CONCLUSIONS
  SV reconstruction might be unnecessary when SV transection is required. Preservation of the IMV on the remnant SV might not prevent sinistral portal hypertension.
authors: Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Masashi
authors: M
authors: Hattori
authors: Tsutomu
authors: T
authors: Fujii
authors: Suguru
authors: S
authors: Yamada
authors: Yoshikuni
authors: Y
authors: Inokawa
authors: Masaya
authors: M
authors: Suenaga
authors: Hideki
authors: H
authors: Takami
authors: Mitsuro
authors: M
authors: Kanda
authors: Hiroyuki
authors: H
authors: Sugimoto
authors: Shuji
authors: S
authors: Nomoto
authors: Kenta
authors: K
authors: Murotani
authors: Akimasa
authors: A
authors: Nakao
authors: Yasuhiro
authors: Y
authors: Kodera
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D013162:Splenic Vein / Q000601:surgery*; D016896:Treatment Outcome