title: New Portal-Superior Mesenteric Vein Reconstructions Using First Jejunal Vein Flap in Pancreaticoduodenectomy.
abstract: Pancreaticoduodenectomy (PD) is the only potential treatment for pancreatic head adenocarcinomas, which are sometimes located close to or invade the portal-superior mesenteric vein (PSMV). Surgeons often attempt to obtain a negative resectional margin after resection of the PSMV. This attempt requires PSMV reconstruction through graft replacements or end-to-end anastomosis; however, possible complications should be concerned including anastomosis stenosis, damage to some of the PSMV branches, prosthetic graft infection, and that associated with autologous graft harvesting. The first jejunal artery and vein are often resected in PD with the intent of lymphadenectomy. In this study, jejunal vein flap was used for PSMV reconstruction without causing damage to any of the PSMV branches in two patients. Here, we describe the new methods of PSMV reconstruction using first jejunal vein flap in PD.
authors.affiliation: Department of Gastroenterological Surgery, JR Tokyo General Hospital, 2-1-3, Yoyogi, Shibuya-ku, Tokyo, 151-8528, Japan. takemuranobu-tky@umin.ac.jp.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takemura
authors.affiliation: Department of Gastroenterological Surgery, JR Tokyo General Hospital, 2-1-3, Yoyogi, Shibuya-ku, Tokyo, 151-8528, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Miki
authors.affiliation: Department of Gastroenterological Surgery, JR Tokyo General Hospital, 2-1-3, Yoyogi, Shibuya-ku, Tokyo, 151-8528, Japan.
authors.forename: Tomoo
authors.initials: T
authors.lastname: Kosuge
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D006801:Humans; D008297:Male; D008642:Mesenteric Veins / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011169:Portal Vein / Q000601:surgery*; D013524:Surgical Flaps; D014656:Vascular Surgical Procedures / Q000379:methods; D014680:Veins / Q000637:transplantation