Laparoscopic pancreaticoduodenectomy with reconstruction of the mesentericoportal vein with the parietal peritoneum and the falciform ligament

Dokmak, Safi; Aussilhou, B.; Calmels, Mélanie; Maghrebi, Houcine; Ftériche, F.S.; Soubrane, Olivier; Sauvanet, Alain

doi:10.1007/s00464-018-6044-0

Cited by 25 publications

(14 citation statements)

References 30 publications

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“…Peritoneal, bovine pericardium and polytetrafluoroethylene material were variably used for venous patches. Postoperative thrombosis was rarely reported [3,15,17] . We found a 5.7% postoperative mortality rate which is in the range of that reported in large registry studies in Europe [20,21] .…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, complex procedures such as renal or splenic artery aneurysm repair, nephrectomy with caval thrombectomy, and kidney and pancreas transplantation have been described in recent years [6][7][8][9][10][11] . As a result of these developments and the increased experience achieved with MIS PDs, small series of MIS pancreatectomies with vascular resection have been reported [3,5,[11][12][13][14][15][16][17][18][19] . The safety and results of this approach remains to be determined.…”

Section: Introductionmentioning

confidence: 99%

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Minimally invasive pancreaticoduodenectomy with venous resection: results of a systematic review

Addeo¹

2020

Mini-invasive Surg

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Aim: Growing experience with minimally invasive pancreaticoduodenectomy (PD) has led surgeons to expand the indications for this approach. We systematically reviewed the literature on minimally invasive PD with venous resection. Methods: The EMBASE, MEDLINE, and Cochrane central databases were systematically searched for articles from January 2010 to January 2020 describing cases of PD with venous resection. The search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The primary outcomes were feasibility and conversion rate. Secondary outcomes were morbidity, mortality, blood loss and 1-year survival. Results: The literature search found 9 studies reporting 140 patients undergoing PD with venous resection. Sixty-six PDs were performed robotically (47.1%). The conversion rate ranged from 0% to 55%, blood loss ranged from 200 to 842 mL, and operative time ranged from 397 to 518 min. There were 82 lateral (58.5%) and 18 segmental (12.8%) PDs with venous resection. One patient had an associated arterial resection (0.7%). A graft was used for venous reconstruction in 28 patients (20%). Eight deaths (5.7%) were reported postoperatively. Conclusion: Minimally invasive pancreatectomies with synchronous lateral venous resections are increasingly reported by highly experienced surgeons in high-volume institutions. Further experience is needed to validate this approach and prove its advantages over open surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Minimally invasive pancreaticoduodenectomy with venous resection: results of a systematic review

Addeo¹

2020

Mini-invasive Surg

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“…However, few studies have reported the technical and oncological feasibility of LPD combined with venous vascular resection 11121314151617. In the current report, we present the case of a patient with pancreatic head cancer who underwent successful LPD with segmental resection of the SMV–SV–PV confluence, resulting in negative surgical margins.…”

Section: Introductionmentioning

confidence: 92%

Laparoscopic pancreaticoduodenectomy with segmental resection of superior mesenteric vein-splenic vein-portal vein confluence in pancreatic head cancer: can it be a standard procedure?

Park

Kang

2018

Ann Hepatobiliary Pancreat Surg

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The feasibility of laparoscopic pancreaticoduodenectomy (LPD) in the treatment of pancreatic cancer is still disputed. However, advances in surgical technique and accumulating experience have led to the use of LPD with combined vascular resection and reconstruction as a safe and feasible procedure, especially in pancreatic cancer with major vascular involvement. A 64-year-old woman presented with obstructive jaundice secondary to pancreatic head cancer. Contrast abdominopelvic computed tomography revealed a pancreatic head tumor measuring approximately 22 mm in diameter that was abutting the first jejunal branch of the superior mesenteric vein at an angle of <180°. The patient underwent LPD, which failed to resect the pancreatic head tumor invading the superior mesenteric vein. Consequently, segmental resection of the confluence of the superior mesenteric vein, splenic vein, and portal vein (SMV/SV/PV) was completely performed in laparoscopic approach without complication. The patient recovered without any event and was discharged on postoperative day 9. LPD combined with vascular resection and reconstruction is feasible in cases involving major blood vessels. Further surgical expertise and education are required before LPD can be used as a standard procedure.

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“…With an increasing rate of surgical resection and vascular reconstruction in HPB surgery, an increasing incidence of complications related to the PV must be anticipated [15][16][17]. Percutaneous transhepatic stenting of the PV has gained acceptance as a safe minimally invasive procedure with promising results [12,[18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

Portal vein stent placement after hepatobiliary and pancreatic surgery

Khan

Kleive

Aandahl

et al. 2020

Langenbecks Arch Surg

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Purpose To evaluate the long-term outcomes of percutaneous transhepatic stent placement for portal vein (PV) stenosis after liver transplantation (LT) and hepato-pancreato-biliary (HPB) surgery. Methods Retrospective study of 455 patients who underwent LT and 522 patients who underwent resection of the pancreatic head between June 2011 and February 2016. Technical success, clinical success, patency, and complications were evaluated for both groups. Results A total of 23 patients were confirmed to have postoperative PV stenosis and were treated with percutaneous transhepatic PV stent placement. The technical success rate was 100%, the clinical success rate was 80%, and the long-term stent patency was 91.3% for the entire study population. Two procedure-related hemorrhages and two early stent thromboses occurred in the HPB group while no complications occurred in the LT group. A literature review of selected studies reporting PV stent placement for the treatment of PV stenosis after HPB surgery and LT showed a technical success rate of 78-100%, a clinical success rate of 72-100%, and a long-term patency of 57-100%, whereas the procedure-related complication rate varied from 0-33.3%. Conclusions Percutaneous transhepatic PV stent is a safe and effective treatment for postoperative PV stenosis/occlusion in patients undergoing LT regardless of symptoms. Due to increased risk of complications, the indication for percutaneous PV stent placement after HPB surgery should be limited to patients with clinical symptoms after an individual assessment.

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Laparoscopic pancreaticoduodenectomy with reconstruction of the mesentericoportal vein with the parietal peritoneum and the falciform ligament

Cited by 25 publications

References 30 publications

Minimally invasive pancreaticoduodenectomy with venous resection: results of a systematic review

Minimally invasive pancreaticoduodenectomy with venous resection: results of a systematic review

Laparoscopic pancreaticoduodenectomy with segmental resection of superior mesenteric vein-splenic vein-portal vein confluence in pancreatic head cancer: can it be a standard procedure?

Portal vein stent placement after hepatobiliary and pancreatic surgery

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