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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Published online: January 31, 2008
Accepted: October 20, 2007
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.