Pancreatectomy for metastasis to the pancreas from colorectal cancer and reconstruction of superior mesenteric vein: a case report

INTRODUCTION: Tumors of the pancreatic head can infiltrate the superior mesenteric vein. In such cases, the deep veins of the lower limbs can serve as suitable autologous conduits for superior mesenteric vein reconstruction after its resection. Few data exist, however, describing the technique and the immediate patency of such reconstruction. CASE REPORT: We present the case of a 70-year-old Caucasian man with a metachronous metastasis of colon cancer and infiltration of the uncinate pancreatic process, on the anterior surface of which the tumor was located. En bloc resection of the tumor was performed with resection of the superior mesenteric vein and reconstruction. A 10 cm segment of the superficial femoral vein was harvested for the reconstruction. The superficial femoral vein segment was inter-positioned in an end-to-end fashion. The post-operative conduit patency was documented ultrasonographically immediately post-operatively and after a six-month period. The vein donor limb presented subtle signs of post-operative venous hypertension with edema, which was managed with compression stockings and led to significant improvement after six months. CONCLUSION: In cases of exploratory laparotomies with high clinical suspicion of pancreatic involvement, the potential need for vascular reconstruction dictates the preparation for leg vein harvest in advance. The superficial femoral vein provides a suitable conduit for the reconstruction of the superior mesenteric vein. This report supports the uncomplicated nature of this technique, since few data exist about this type of reconstruction.