Pancreaticoduodenectomy (PD) is the only potentially curative treatment for patients with adenocarcinoma
of the pancreatic head. Advances in surgical technique and perioperative care have
resulted in declining morbidity and mortality rates that have enabled surgeons to
extend resection to include en bloc resection and reconstruction of the superior mesenteric
portal venous confluence (SMV-PV) to extend operative candidacy to patients with locally
advanced (T4) tumors. Increased comfort with the technical aspects of major venous
resection and reconstruction is now the norm in many high-volume pancreatic surgery
units. This report documents our successful treatment of a patient who developed a
potentially lethal acute SMV-PV thrombosis on the first postoperative day after PD
using aggressive anticoagulation and early operative thrombectomy with SMV-PV reconstruction.
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References
- Splanchnic venous thrombosis.in: Bland K. The practice of general surgery. W.B. Saunders, Philadelphia, Pa2002: 447-451
- Efficacy of venous reconstruction in patients with adenocarcinoma of the pancreatic head.J Gastrointest Surg. 2003; 7: 1089-1095
- Durability of portal venous reconstruction following resection during pancreaticoduodenectomy.J Gastrointest Surg. 2006; 10: 1371-1375
- Diagnosis of portal vein thrombosis: value of color Doppler imaging.Am J Roentgenol. 1991; 157: 293-296
- Superior mesenteric vein thrombosis complicating pancreatoduodenectomy: successful treatment by thrombectomy.Ann Surg. 1968; 167: 106-111
Article info
Publication history
Published online: January 31, 2008
Accepted:
October 20,
2007
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
