Pancreaticoduodenectomy with venous reconstruction using cold‐stored vein allografts: long‐term results of a single center experience

Meniconi, Roberto Luca; Santoro, Roberto; Guglielmo, Nicola; Vennarecci, Giovanni; Lepiane, Pasquale; Colasanti, Marco; Ettorre, Giuseppe Maria

doi:10.1002/jhbp.299

Cited by 19 publications

(12 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Various MPV reconstruction techniques have been described, including the use of synthetic PTFE grafts [9], bovine pericardium, allografts [5,10], autografts [7,11,12], as well as different segmental or tangential resections with primary end-to-end anastomosis or venorrhaphy [13,14], resulting in an overall patency rate between 70 and 90% [9][10][11][12][13][14]. Each technique has its own advantages and disadvantages, so far the optimal reconstruction strategy is still unclear.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of mesentericoportal vein reconstruction by autologous falciform ligament during pancreaticoduodenectomy—cohort study

et al. 2021

View full text Add to dashboard Cite

Background Mesentericoportal vein (MPV) resection in pancreatic ductal adenocarcinoma (PDAC) surgery has become a common procedure. A few studies had described the use of falciform ligament (FL) for MPV reconstruction and received encouraging preliminary effects. Aims This study was designed to explore the feasibility and efficacy of this technique compared with others. Methods Patients who underwent pancreaticoduodenectomy (PD) with MPV resection for PDAC from 2009 to 2018 were enrolled. Medical records were retrospectively reviewed, MPV reconstructions using FL were distinguished and compared with other techniques. Results 146 patients underwent MPV reconstruction, and 13 received FL venoplasty. Other reconstruction techniques included primary end-to-end anastomosis (primary, n = 30), lateral venorrhaphy (LV, n = 19), polytetrafluoroethylene conduit interposition (PTFE, n = 24), iliac artery (IA) allografts interposition (n = 47), and portal vein (PV) allografts interposition (n = 13). FL group holds the advantages of shortest operation time (p = 0.023), lowest blood loss (p = 0.109), and shortest postoperative hospital stay (p = 0.125). The grouped patency rates of FL, primary, LV, PTFE, IA, and PV were 100%, 90%, 68%, 54%, 68%, and 85% respectively. Comparison displayed that FL had the highest patency rate (p = 0.008) and lowest antiplatelet/anticoagulation proportion (p = 0.000). Complications and long-term survival were similar among different techniques. The median survival time of patent group (24.0 months, 95% CI: 22.0–26.0) was much longer than that of the thrombosed (17.0 months, 95% CI: 13.7–20.3), though without significant difference (P = 0.148). Conclusions PD with MPV resection and reconstruction by FL is safe, feasible, and efficacious, it might provide a potential benefit for patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Feasibility of mesentericoportal vein reconstruction by autologous falciform ligament during pancreaticoduodenectomy—cohort study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…There are very few studies reporting allograft vein graft for PV-SMV reconstruction. Roberto et al reported that allograft vein graft for PV-SMV reconstruction did not require either ABO matching or immunosuppressive therapy [ 26 ]. Manju D. Chandrasegaram et al reported that there is high heterogeneity in the use of anticoagulation policy, and the acceptable perioperative outcomes were achieved with an anticoagulation policy or no anticoagulation policy after venous resection [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Pancreatoduodenectomy combined with portal-superior mesenteric vein resection and reconstruction with interposition grafts for cancer: a meta-analysis

et al. 2017

View full text Add to dashboard Cite

The use of interposition grafts for portal-superior mesenteric vein (PV-SMV) reconstruction during pancreatoduodenectomy (PD) with venous resection (VR) for localized periampullary tumors is a controversial topic. The present meta-analysis aimed to evaluate the perioperative and long-term outcomes in patients who received interposition grafts for PV-SMV reconstruction after PD with VR. The correlative databases were systematically searched to identify relevant trials comparing vein grafts versus no vein grafts during PD with VR. 14 studies including 257 patients with vein grafts and 570 patients without vein grafts were extracted. The meta-analysis indicated no difference in perioperative morbidity, mortality, or thrombosis between the two groups, but the vein graft group was associated with a significantly increased venous thrombosis rate (≥ 6 months) (odds ratio [OR] = 2.75; 95% confidence interval [CI], 1.32-5.73; P = .007). The autologous vein group subgroup analysis also revealed a significantly increased vein thrombosis rate (OR = 3.13; 95% CI, 1.45-6.76; P = .004) between the two groups. Meanwhile, the prosthetic vein group subgroup analysis indicated no difference. Additionally, the oncological value of vein grafts during PD for pancreatic cancer survival was analyzed and revealed no difference in 1-year, 3-year, or 5-year survival between the two groups. Using interposition grafts for PV-SMV reconstruction is safe and effective, and has perioperative outcomes and long-term survival rates compared to those with no vein grafts during PD with VR. However, the lower long-term vein patency rate in patients with vein grafts indicate that interposition grafts may be more likely to lose function.

show abstract

“…Various vascular reconstructions using primary venous closure, end-to-end anastomosis, using autologous, allogenous or prosthesis graft were described in the worldwide literature. The overall patency rate of the above-mentioned reconstructions is between 70 and 90% [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Each technique has its own advantages and disadvantages.…”

Section: Venous Resectionsmentioning

confidence: 99%

Vascular Resection in Pancreatectomy—Is It Safe and Useful for Patients with Advanced Pancreatic Cancer?

Jabłońska

Król

Mrowiec

2022

Cancers

View full text Add to dashboard Cite

Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease with poor prognosis and increased incidence. Surgical resection R0 remains the most important treatment to prolong survival in PDAC patients. In borderline and locally advanced cancer, vascular resection and reconstruction during pancreatectomy enables achieving R0 resection. This study is a comprehensive review of the literature regarding the role of venous and arterial resection with vascular reconstruction in the treatment of pancreatic cancer. The literature review is focused on the use of venous and arterial resection with immediate vascular reconstruction in pancreaticoduodenectomy. Different types of venous and arterial resections are widely described. Different methods of vascular reconstructions, from primary vessel closure, through end-to-end vascular anastomosis, to interposition grafts with use autologous veins (internal jugular vein, saphenous vein, superficial femoral vein, external or internal iliac veins, inferior mesenteric vein, and left renal vein or gonadal vein), autologous substitute grafts constructed from various parts of parietal peritoneum including falciform ligament, cryopreserved and synthetic allografts. The most attention was given to the most common venous reconstructions, such as end-to-end anastomosis and interposition graft with the use of an autologous vein. Moreover, we presented mortality and morbidity rates as well as vascular patency and survival following pancreatectomy combined with vascular resection reported in cited articles.

show abstract

Pancreaticoduodenectomy with venous reconstruction using cold‐stored vein allografts: long‐term results of a single center experience

Abstract: Our experience with cold-stored vein allografts suggests that this technique is a useful option for treating major vascular resections during pancreaticoduodenectomy with good results on follow-up.

Cited by 19 publications

References 31 publications

Feasibility of mesentericoportal vein reconstruction by autologous falciform ligament during pancreaticoduodenectomy—cohort study

Feasibility of mesentericoportal vein reconstruction by autologous falciform ligament during pancreaticoduodenectomy—cohort study

Pancreatoduodenectomy combined with portal-superior mesenteric vein resection and reconstruction with interposition grafts for cancer: a meta-analysis

Vascular Resection in Pancreatectomy—Is It Safe and Useful for Patients with Advanced Pancreatic Cancer?

Contact Info

Product

Resources

About