[Surgery of the portal vein in the resection of carcinoma of the biliary tract and pancreas].

Resection and reconstruction of the portal vein were performed in 5 cases of total pancreatectomy for pancreatic carcinoma, and in 7 cases of right hepatic trisegmentectomy for carcinoma of the gall bladder, or for intra- or extrahepatic bile ducts. Techniques of the surgery were described, especially on the necessity of "insert anastomosis" and on the indication of vessel implantation. No postoperative mortality and morbidity due to the reconstruction of portal vein was observed. Early thrombotic obstruction was observed only in one case which was the first case of this procedure. Late stenosis of the reconstructed vein due to the invasion of carcinoma was angiographically observed in 3 cases. Conclusively, this procedure can safely be performed in the resection of carcinoma of those organs. Improvements in resectability and late prognosis of the carcinoma may be expected. However, acquirement of the basic technique of vascular surgery is necessary, especially in the reconstruction of the portal vein at the hepatic pedicle.