BACKGROUND: When the mesenterico-portal vein is stenosed due to tumor related compression, venous collaterals develop and flow occurs antegrade towards the portal vein through the collateral tributaries. Undertaking pancreatoduodenectomy for pancreatic cancer in this setting may result in significant blood loss during the process of ligation of these tributaries. DESCRIPTION OF TECHNIQUE: We describe the technique of endovascular stenting of the mesenterico-portal vein to reduce flow within these collateral tributaries and hence blood loss, to facilitate extended pancreatoduodenectomy and vein resection. CONCLUSION: Percutaneous transhepatic placement of endovascular stent into a stenotic mesentero-portal vein facilitates pancreatoduodenectomy by reducing operative time, which would otherwise be required in dealing with the extensive venous collaterals and hence also reducing blood loss.
BACKGROUND: When the mesenterico-portal vein is stenosed due to tumor related compression, venous collaterals develop and flow occurs antegrade towards the portal vein through the collateral tributaries. Undertaking pancreatoduodenectomy for pancreatic cancer in this setting may result in significant blood loss during the process of ligation of these tributaries. DESCRIPTION OF TECHNIQUE: We describe the technique of endovascular stenting of the mesenterico-portal vein to reduce flow within these collateral tributaries and hence blood loss, to facilitate extended pancreatoduodenectomy and vein resection. CONCLUSION: Percutaneous transhepatic placement of endovascular stent into a stenotic mesentero-portal vein facilitates pancreatoduodenectomy by reducing operative time, which would otherwise be required in dealing with the extensive venous collaterals and hence also reducing blood loss.
Authors: Frank Wang; Ranjan Arianayagam; Anthony Gill; Vikram Puttaswamy; Michael Neale; Sivakumar Gananadha; Thomas J Hugh; Jaswinder S Samra Journal: J Am Coll Surg Date: 2012-07-03 Impact factor: 6.113
Authors: Taylor S Riall; John L Cameron; Keith D Lillemoe; Jordan M Winter; Kurtis A Campbell; Ralph H Hruban; David Chang; Charles J Yeo Journal: Surgery Date: 2006-08-28 Impact factor: 3.982
Authors: Jakob R Izbicki; Emre F Yekebas; Tim Strate; Claus F Eisenberger; Stefan B Hosch; Katharina Steffani; Wolfram T Knoefel Journal: Ann Surg Date: 2002-07 Impact factor: 12.969