Choi Sung Hoon, Hwang Ho Kyoung, Kang Chang Moo, Lee Woo Jung
Division of Biliopancreas, Department of Surgery, Yonsei University College of Medicine. Seoul, South Korea.
JOP. 2011 May 6;12(3):234-40.
Various techniques for reconstruction after superior mesenteric-splenic-portal vein confluence resection during pancreaticoduodenectomy have been introduced. A certain kind of vascular grafting may be necessary especially when long segmental resection of superior mesenteric-splenic-portal vein confluence is required.
We herein report the cases of two patients who underwent left renal vein grafting in a pancreaticoduodenectomy with combined resection of the long segment of the superior mesenteric-splenic-portal vein confluence for pancreatic head cancer following neoadjuvant concurrent chemoradiation therapy as well as their long-term outcomes with graft patency without deterioration of renal function.
Our experience with these two cases indicates that an autologous interposition graft using the left renal vein may be considered a safe and convenient conduit in the case of long segmental resection of the superior mesenteric-splenic-portal vein confluence during a pancreaticoduodenectomy following preoperative neoadjuvant chemoradiation therapy.
已经介绍了在胰十二指肠切除术期间进行肠系膜上-脾-门静脉汇合处切除术后的各种重建技术。特别是当需要对肠系膜上-脾-门静脉汇合处进行长节段切除时，可能需要某种血管移植。
我们在此报告两例患者的病例，这两名患者在新辅助同步放化疗后，因胰头癌接受了胰十二指肠切除术，并联合切除了肠系膜上-脾-门静脉汇合处的长节段，术中进行了左肾静脉移植，以及其长期预后，移植血管通畅且肾功能未恶化。
我们对这两例病例的经验表明，在术前新辅助放化疗后的胰十二指肠切除术期间，对于肠系膜上-脾-门静脉汇合处长节段切除的情况，使用左肾静脉进行自体间置移植可被认为是一种安全便捷的管道。
