Portal vein resection without reconstruction during Appleby operation in a patient with pancreatic body carcinoma with cavernous transformation

Ankihito Horiguchi, S. Miyakawa, K. Mizuno, S. Ishihara, K. Miura

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

The prognosis of pancreatic body carcinoma has been poor due to cancerous invasion of major vessels. Resection of the involved vessels may improve resectability and prognosis. We report a patient who had a pancreatic body carcinoma with cavernous transformation of the portal vein, in whom the portal vein was resected without reconstruction during an Appleby operation. A 67 year-old man was admitted for evaluation of back pain. Enhanced computed tomography showed no main trunk of the portal vein but a developed collateral circulation. Celiac angiography revealed encasement of the common hepatic, splenic and celiac artery. Venous angiography revealed obstruction of the portal and splenic veins with cavernous transformation surrounding these veins. Pre-operative diagnosis was carcinoma in the pancreatic body, which invaded the portal vein, the celiac and common hepatic arteries. The Appleby operation combined with resection of the portal vein without reconstruction could be performed, by preserving collateral vessels and monitoring hepatic venous oxygen saturation (ShvO2) to prevent hepatic ischemia caused by occlusion of the portal vein. The post-operative course was uneventful.

Original languageEnglish
Pages (from-to)2628-2630
Number of pages3
JournalHepato-gastroenterology
Volume46
Issue number28
Publication statusPublished - 07-10-1999

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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