Whipple operation with resection of portal/upper mesenteric vein without vascular reconstruction for tumoral thrombosis of vessels of the portal vein system
Introduction. Experience of performance of pancreaticoduodenal resection with resection and complete ligature of upper mesenteric or portal vein in 4 patients for total tumoral occlusion of the portal vein system vessels by pancreatic head and processus uncinatus is adduced.
Маterials and methods. In 2015 - 2017 yrs period 4 patients were operated for tumor of right anatomic-surgical pancreatic segment with tumoral invasion into portal/upper mesenteric vein with total (absence of the blood flow) or subcompensated (over 80%) thrombosis of these vessels.
Results. In 3 patients during pancreatico-duodenal resection vascular reconstruction was not performed and distal end of upper mesenteric vein was sutured tightly. In one patient a circular venous anastomosis was formatted in end to end fashion between portal vein and dilated collateral vein, which have branched from upper mesenteric vein. At average, the operation duration have constituted (390 ± 47) min and postoperative period - (18 ± 4.2) days, with lethality 25% (one woman-patient died).
Conclusion. Pancreatico-duodenal resection with ligature of upper mesenteric vein without formation of vascular anastomosis in its tumoral occlusion is secure and possible in thoroughly selected patients.
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