Anatomic study of portal vein: transpancreatic vessels injuries approach

Abstract

Introduction: The commitment of the great blood-vessels make up a situation of great complexity and a high rate of the complications and mortality patients with abdominal trauma. The injury of the portal vein matters because of the difficulty on the diagnosis and the approach surgery. Objective: To set the standard on the transverse section of the pancreas looking for a safer surgical access to repair the portal vein injuries. Methods: A quantitative analysis was performed to characterize the anatomical relationship between the portal vein and their tributaries relating them to the pancreas. On these corpses, the measurements of a anatomical triangle were studied. It base was the upper limit of the superior mesenteric vein and the initial portion of the portal vein; the apex, a point located on the upper limit of the confluence of the splenic vein and superior mesenteric vein, situated at the middle line of the superior mesenteric_ vein. Results: The portal vein is formed 3.24cm from the internal border of the duodenal arc at a distance of 1.61cm and 1.07 from the inferior and superior pancreas borders, respectively. Conclusion: The present study allow us to conclude that, to have access to the origin of the portal vein, in case of trauma of this vessel, one should proceed a transverse section of the neck of the pancreas next to the superior mesenteric vein, because its confluence with splenic vein occur, on average, 1.07cm and 1.61cm from the superior and inferior border of the gland, respectively.

Pattern and Position of Portal Vein Formation in a Kenyan Population

“…Moreover, the risks of PV injury following blunt or penetrating abdominal trauma are real which necessitates its surgical repair. 11 The current study did not report any congenital absence of the PV underscoring the rarity of the same as previously reported. The prevalence of Type I pattern of formation has been reported to range from 40% to 84.62%.…”

“…Various attempts have been made to describe the point of formation of the PV relative to the neck of the pancreas or the lumbar vertebrae. 11 Awareness of the variant anatomy involved is beneficial for both surgeons and interventional radiologists. In the current study, it was observed that the point of PV formation was always posterior to the neck of the pancreas.…”

Multiple Anatomical Variations of the Hepatic Pedicle: Case Report and Clinical Application

“…Variations regarding the origin and course of the celiac trunk and hepatic arteries are well described by the literature; also, variations regarding the bile ducts. For its part, the venous component of the hepatic pedicle shows a normal location in over 90% of cases, and variations regarding portal vein location are not frequent compared to portal vein formation (Mantovani et al, 2002;Bergman et al, 2006).…”

“…This work will show one case of multiple and simultaneous variations of the hepatic pedicle, which individually represent a low-frequency variation occurrence; but altogether, it results in a rare case. Our objective is to show the importance of knowing the normal anatomy of the hepatic pedicle and its variations, taking them into account during surgery, either open hepatobiliary-pancreatic or laparoscopic surgery, and in cases of hepatobiliary trauma, in order to avoid lesions that can bring serious complications that can consequently jeopardize the patient's life (Michels, 1953(Michels, , 1962Vandamme et al, 1969;Rygaard et al, 1986;Hiatt et al, 1994;Marin et al, 2001;Covey et al, 2002;Mantovani et al;Prabhasavat & Homgade, 2008).…”