Abstract: Objective:To investigate the application value of vascular allotransplantation in the pancreaticoduodenectomy combined with superior mesenteric vein and/or portal vein (SMV/PV) partial resection and vascular reconstruction.
Methods:The clinical data of 2 patients with pancreatic head carcinoma who underwent pancreaticoduodenectomy combined with SMV/PV partial resection at the First Affiliated Hospital of Sun Yatsen University between August 2014 and October 2014 were retrospectively analyzed. The blood types of case 1 and case 2 were types A and O. Since SMV/PV surrounded by tumor was detected during the operation with the length of surrounded part of 6 cm, and pancreaticoduodenectomy combined with SMV/PV partial resection and vascular allotransplantation were performed. Two cases were followed up by outpatient examination and telephone interview till June 2015. The index observed during the followup included tumor metastasis and recurrence.
Results:Two cases underwent successful operation without perioperative complications. The operation time, splenic vein occlusion time, SMV/PV occlusion time, volume of intraoperative blood loss, volume of red blood cell (RBC) transfusion, volume of plasma transfusion and length of resected blood vessel were 480 minutes, 45 minutes, 30 minutes, 3 000 mL, 10 U, 600 mL and 7 cm in case 1 and 480 minutes, 30 minutes, 25 minutes, 600 mL, 2 U, 400 mL and 7 cm in case 2. Two cases took food at postoperative day 5, abdominal drainage tube was removed at postoperative day 5 and 7 with good recovery. Case 1 and Case 2 were discharged from hospital at postoperative day 21 and 14, respectively. Two cases had good survival without metastasis and recurrence of tumors at the end of followup.Conclusion:Vascular allotransplantation is safe and feasible in the pancreaticoduodenectomy combined with SMV/PV partial resection for pancreatic head carcinoma, with a satisfactory shortterm outcome.