Interposition graft with polytetrafluoroethylene for mesenteric and portal vein reconstruction after pancreaticoduodenectomy

Br J Surg. 2009 Mar;96(3):247-52. doi: 10.1002/bjs.6483.

Abstract

Background: Portal vein-superior mesenteric vein resection is frequently required after surgical resection of tumours of the pancreas head. The ideal graft for portal vein reconstruction (PVR) remains undefined.

Methods: Between May 2000 and July 2007, 28 patients had portal vein-superior mesenteric vein resection and PVR during pancreaticoduodenectomy. Their clinical reports were reviewed retrospectively with specific attention to the methods of PVR and outcomes.

Results: Ten patients had PVR with primary anastomosis, seven had PVR with autologous vein, one had a polytetrafluoroethylene (PTFE) patch, one did not have PVR and nine had PVR with a PTFE interposition graft. There was no infection after PTFE grafting. Six patients had PVR thrombosis after surgery: four after primary anastomosis, one after interposition PTFE and one after vein repair.

Conclusion: PTFE appeared to be an effective and safe option as an interposition graft for portomesenteric venous reconstruction after pancreaticoduodenectomy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation / methods
  • Female
  • Humans
  • Male
  • Mesenteric Veins / surgery*
  • Middle Aged
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy / methods*
  • Polytetrafluoroethylene / therapeutic use*
  • Portal Vein / surgery*
  • Postoperative Complications / etiology*

Substances

  • Polytetrafluoroethylene