Surgical outcome of autologous external iliac vein grafting in cases of hepato-pancreato-biliary malignancy: how I do it

J Gastrointest Surg. 2012 Aug;16(8):1590-6. doi: 10.1007/s11605-012-1933-3. Epub 2012 Jun 15.

Abstract

Introduction: Operative indications and surgical outcomes of an autologous graft usage for hepato-pancreato-biliary malignancy have not been adequately investigated. Sixty consecutive patients who underwent sleeve resection of the portal vein (PVR, n = 45) or hepatic vein (HVR, n = 15) and right external iliac vein (REIV) graft reconstruction were reviewed.

Results: Median graft length and reconstruction time were 3 cm (range, 2-7 cm) and 25 min (range, 16-40 min), respectively. Overall morbidity and surgical mortality were acceptable at 48 % and 1.6 %. Postoperative graft obstructions were seen in one patient with PVR and two patients with HVR; however, these patients did not suffer from the life-threatening complications.

Conclusion: REIV graft reconstruction shows acceptable morbidity and mortality. Our strategy may extend the operative indications for advanced disease and impaired liver function.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biliary Tract Neoplasms / pathology
  • Biliary Tract Neoplasms / surgery*
  • Female
  • Hepatic Veins / pathology
  • Hepatic Veins / surgery*
  • Humans
  • Iliac Vein / transplantation*
  • Kaplan-Meier Estimate
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Portal Vein / pathology
  • Portal Vein / surgery*
  • Postoperative Complications
  • Survival Rate
  • Transplantation, Autologous
  • Treatment Outcome
  • Vascular Grafting / methods*
  • Vascular Grafting / mortality