How-I-do-it: a novel technique of portal vein-right gastroepiploic vein side-to-side anastomosis to improve gastric venous congestion following total pancreatectomy: a retrospective cohort study and literature review (with video).

IF 2.1 3区医学 Q2 SURGERY

Langenbeck's Archives of Surgery Pub Date : 2025-04-25 DOI:10.1007/s00423-025-03702-y

Kenta Aso, Ryuji Yoshioka, Atsushi Takahashi, Shoichi Irie, Yoshinori Takeda, Yoshihiro Hirata, Takaaki Kato, Hirofumi Ichida, Yoshihito Kotera, Yoshihiro Mise, Akio Saiura

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引用次数: 0

Abstract

Purpose: The aim of the present study was to evaluate the outcomes and preventive techniques for gastric venous congestion (GVC) following total pancreatectomy (TP), with a focus on gastric venous drainage reconstruction.

Methods: This retrospective single-center study included patients who underwent TP between January 2019 and June 2024, encompassing both primary one-step TP and planned elective completion pancreatectomy following either pancreatoduodenectomy (PD) or distal pancreatectomy (DP). Intraoperative evaluation and reconstruction of gastric venous drainage were performed when GVC was observed. Demographic, clinical, technical, perioperative, and postoperative data were analyzed.

Results: Sixteen patients underwent either one-step TP (n = 4) or elective completion pancreatectomy (n = 12), including four following DP and eight following PD. Intraoperative GVC was detected in two patients, necessitating portal vein (PV)-right gastroepiploic vein (RGEV) side-to-side anastomosis. No major complications occurred in these patients, and no GVC was observed during the postoperative follow-up period (mean: 39.8 months, range: 2.1-60.7 months).

Conclusion: In cases where preservation of gastric drainage veins is not feasible, PV-RGEV side-to-side anastomosis can be a convenient and useful option to resolve intraoperative GVC.

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我是怎么做的：一种新的门静脉-右胃网膜静脉侧对侧吻合技术改善全胰腺切除术后胃静脉充血：回顾性队列研究和文献综述（带视频）。

目的：本研究的目的是评估全胰切除术（TP）后胃静脉充血（GVC）的结局和预防技术，重点是胃静脉引流重建。方法：本回顾性单中心研究纳入了2019年1月至2024年6月期间接受TP的患者，包括原发性一步TP和计划在胰十二指肠切除术（PD）或远端胰腺切除术（DP）后进行的选择性完成胰切除术。术中观察GVC时进行胃静脉引流的评价和重建。对人口统计学、临床、技术、围手术期和术后数据进行分析。结果：16例患者接受了一步TP （n = 4）或选择性完全胰切除术（n = 12），其中DP后4例，PD后8例。2例患者术中发现GVC，需行门静脉(PV)-右胃网膜静脉（RGEV）侧侧吻合。术后随访期间（平均39.8个月，范围2.1 ~ 60.7个月）均未见GVC发生。结论：在不能保留胃引流静脉的情况下，PV-RGEV侧对侧吻合是解决术中胃静脉瘘的一种方便、有效的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Langenbeck's Archives of Surgery 医学-外科

CiteScore

3.30

自引率

8.70%

发文量

342

审稿时长

4-8 weeks

期刊介绍： Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.