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Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension

BACKGROUND: Left‐sided portal hypertension is usually found in patients undergoing pancreaticoduodenectomy (PD) with spleno‐mesenterico‐portal (S‐M‐P) confluence resection. This study is to explore the outcomes of S‐M‐P confluence reconstruction after resection by using bifurcated allogeneic vein. M...

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Autores principales: Zhang, Xingmao, Wu, Qiao, Fan, Hua, He, Qiang, Lang, Ren
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8366088/
https://www.ncbi.nlm.nih.gov/pubmed/34190423
http://dx.doi.org/10.1002/cam4.4093
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author Zhang, Xingmao
Wu, Qiao
Fan, Hua
He, Qiang
Lang, Ren
author_facet Zhang, Xingmao
Wu, Qiao
Fan, Hua
He, Qiang
Lang, Ren
author_sort Zhang, Xingmao
collection PubMed
description BACKGROUND: Left‐sided portal hypertension is usually found in patients undergoing pancreaticoduodenectomy (PD) with spleno‐mesenterico‐portal (S‐M‐P) confluence resection. This study is to explore the outcomes of S‐M‐P confluence reconstruction after resection by using bifurcated allogeneic vein. METHODS: Clinicopathologic data of patients who underwent extensive PD with S‐M‐P confluence resection for carcinoma of pancreatic head/uncinate process in our hospital between December 2011 and August 2018 were retrospectively reviewed and clinical outcomes of vein reconstruction after resection were analyzed. RESULTS: Of the 37 patients enrolled, S‐M‐P reconstruction by bifurcated allogeneic vein was performed in 24 cases (group 1) and simply splenic vein ligation in 13 cases (group 2). Items including pathological results, blood loss, and complications were comparable between the two groups, operation time was longer in group 1 (573.8 vs. 479.2 min, p = 0.018). Significantly decreased platelet count (205.9 vs. 133.1 × 10(9)/L, p = 0.001) and increased splenic volume (270.9 vs. 452.2 ml, p < 0.001) were observed in group 2 at 6 months after operation. The mean splenic hypertrophy ratio was 1.06 in group 1 and 1.63 in group 2, respectively (p < 0.001). There were four patients with varices were found in group 2, none in group 1. CONCLUSIONS: Without increased complications, reconstructing S‐M‐P confluence by bifurcated allogeneic vein after resection may help to avoid left‐sided portal hypertension.
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spelling pubmed-83660882021-08-23 Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension Zhang, Xingmao Wu, Qiao Fan, Hua He, Qiang Lang, Ren Cancer Med Clinical Cancer Research BACKGROUND: Left‐sided portal hypertension is usually found in patients undergoing pancreaticoduodenectomy (PD) with spleno‐mesenterico‐portal (S‐M‐P) confluence resection. This study is to explore the outcomes of S‐M‐P confluence reconstruction after resection by using bifurcated allogeneic vein. METHODS: Clinicopathologic data of patients who underwent extensive PD with S‐M‐P confluence resection for carcinoma of pancreatic head/uncinate process in our hospital between December 2011 and August 2018 were retrospectively reviewed and clinical outcomes of vein reconstruction after resection were analyzed. RESULTS: Of the 37 patients enrolled, S‐M‐P reconstruction by bifurcated allogeneic vein was performed in 24 cases (group 1) and simply splenic vein ligation in 13 cases (group 2). Items including pathological results, blood loss, and complications were comparable between the two groups, operation time was longer in group 1 (573.8 vs. 479.2 min, p = 0.018). Significantly decreased platelet count (205.9 vs. 133.1 × 10(9)/L, p = 0.001) and increased splenic volume (270.9 vs. 452.2 ml, p < 0.001) were observed in group 2 at 6 months after operation. The mean splenic hypertrophy ratio was 1.06 in group 1 and 1.63 in group 2, respectively (p < 0.001). There were four patients with varices were found in group 2, none in group 1. CONCLUSIONS: Without increased complications, reconstructing S‐M‐P confluence by bifurcated allogeneic vein after resection may help to avoid left‐sided portal hypertension. John Wiley and Sons Inc. 2021-06-30 /pmc/articles/PMC8366088/ /pubmed/34190423 http://dx.doi.org/10.1002/cam4.4093 Text en © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Zhang, Xingmao
Wu, Qiao
Fan, Hua
He, Qiang
Lang, Ren
Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension
title Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension
title_full Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension
title_fullStr Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension
title_full_unstemmed Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension
title_short Reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension
title_sort reconstructing spleno‐mesenterico‐portal cofluence by bifurcated allogeneic vein in local advanced pancreatic cancer—a feasible method to avoid left‐sided portal hypertension
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8366088/
https://www.ncbi.nlm.nih.gov/pubmed/34190423
http://dx.doi.org/10.1002/cam4.4093
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