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Chapter-03 Vascular Resection and Reconstruction in Pancreaticoduodenectomy

BOOK TITLE: Gastrointestinal Surgery Series: Pancreas and Hepatobiliary Surgery

Author
1. Waage Anne
2. Kleive Dyre
3. Labori Knut Jorgen
ISBN
9789352702602
DOI
10.5005/jp/books/14149_4
Edition
1/e
Publishing Year
2018
Pages
8
Author Affiliations
1. Oslo University Hospital, Oslo, Norway
2. Oslo University Hospital, Oslo, Norway
3. Oslo University Hospital, Oslo, Norway
Chapter keywords
Arterial resection, AR, pancreaticoduodenectomy, PD, venous resection, PDVR, late thrombosis, transverse venorrhaphy, portal vein, PV, superior mesenteric vein, SMV

Abstract

The technical feasibility for venous and arterial resection (AR) and reconstruction during pancreatic surgery was first reported in a substantial series by Fortner in 1983. Pancreatic ductal adenocarcinoma is the most common indication for pancreaticoduodenectomy (PD). The prognosis is poor even in potentially curative resections (R0). Different types of reconstruction techniques have been described, and the optimal technique has not yet been established. Some are in favor of reconstruction without graft. The optimal reconstructive technique in pancreaticoduodenectomy with venous resection (PDVR) in regard to late thrombosis has recently been investigated by Dua et al. finding no cases of late thrombosis in patients reconstructed with primary end-to-end anastomosis or transverse venorrhaphy.

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