title: Domino Reconstruction of the Portal Vein Using the External Iliac Vein and an ePTFE Graft in Pancreatic Surgery.
abstract: In the portal vein resection of long distance, an interposition by autologous vein is mandatory. External iliac vein (EIV) has been used, but harvesting the EIV is associated with severe venous congestion of the affected lower extremity. We have reconstructed the EIV using a ringed expanded polytetrafluoroethylene (ePTFE) graft.
  
  
  
  Thirteen patients underwent this surgery. The right EIV was used for reconstructing the portal vein, and the retrieved portion of EIV was interposed by the ePTFE graft. We evaluated size and length of the graft, graft patency, girth of thigh, time for reconstruction of EIV, and graft infection.
  
  
  
  ePTFE grafts of 8 or 10 mm in diameter were used. The length of ePTFE graft used was 4.4 ± 0.5 cm. Graft patency was kept in 76.9% patients. Graft obstruction was encountered in three patients, and the girth of right thigh increased by about 10 cm. Time for reconstruction of EIV was 29.5 ± 6.8 min. Graft infection did not occur in any patients.
  
  
  
  Reconstruction of the EIV using a ringed ePTFE graft seems to be a feasible option for preventing the swelling of the affected lower extremity after procurement of EIV for repairing the portal vein.
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan. masato@gipc.akita-u.ac.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshioka
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Uchinami
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: Masatake
authors.initials: M
authors.lastname: Iida
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyazawa
authors.affiliation: Department of Cellular and Organ Pathology, Akita University Graduate School of Medicine, Akita, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoshida
authors.affiliation: Department of Gastroenterological Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007084:Iliac Vein / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D016577:Pancreaticoduodenectomy; D011138:Polytetrafluoroethylene; D011169:Portal Vein / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000295:instrumentation / Q000379:methods*
chemical_list: D011138:Polytetrafluoroethylene
keywords: Graft; Iliac vein; Portal vein; Reconstruction; ePTFE