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Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy

BACKGROUND: The aims of the present study were to demonstrate the anatomical change of superior mesenteric vein (SMV) branches and to show how the Cattell Braasch maneuver facilitates a safer ligation of these venous branches during a pancreatoduodenectomy (PD). METHODS: Between January 2010 and Dec...

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Autores principales: Akita, Masayuki, Maeda, Eri, Nishimura, Tohru, Abe, Koichiro, Kozuki, Akihito, Yokoyama, Kunio, Tanaka, Tomohiro, Kishi, Shinji, Kaneda, Kunihiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425086/
https://www.ncbi.nlm.nih.gov/pubmed/34496813
http://dx.doi.org/10.1186/s12893-021-01338-5
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author Akita, Masayuki
Maeda, Eri
Nishimura, Tohru
Abe, Koichiro
Kozuki, Akihito
Yokoyama, Kunio
Tanaka, Tomohiro
Kishi, Shinji
Kaneda, Kunihiko
author_facet Akita, Masayuki
Maeda, Eri
Nishimura, Tohru
Abe, Koichiro
Kozuki, Akihito
Yokoyama, Kunio
Tanaka, Tomohiro
Kishi, Shinji
Kaneda, Kunihiko
author_sort Akita, Masayuki
collection PubMed
description BACKGROUND: The aims of the present study were to demonstrate the anatomical change of superior mesenteric vein (SMV) branches and to show how the Cattell Braasch maneuver facilitates a safer ligation of these venous branches during a pancreatoduodenectomy (PD). METHODS: Between January 2010 and December 2019, 97 patients with peripancreatic tumors underwent pancreatectomy. We retrospectively reviewed preoperative triple-phase enhanced computed tomography (CT) images and analyzed variations in SMV branches. Anatomical changes in SMV branches after the Cattell Braasch technique were observed using our operation video and illustrations. RESULTS: The first jejunal vein (J1v) in 75% of patients ran posterior to the superior mesenteric artery (SMA), while the remainder (25%) ran anterior to it. The inferior pancreatoduodenal vein (IPDV) was preoperatively detected in 91% of patients. The IPDV drained into the J1v in 74% of patients and into the SMV in 37%. After the Cattell Braasch maneuver, the J1v which ran posterior to the SMA now was found to lie to the right anterolateral side the SMA and the visualization of both the J1v and the IPDV were much more clearly visualized. CONCLUSIONS: The most frequent venous variation was the IPDV draining into the J1v posterior to the SMA. After the Cattell Braasch maneuver, the IPDV was now located to the right anterolateral anterior aspect of the SMA which facilitates its visualization and should allow a safer ligation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-021-01338-5.
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spelling pubmed-84250862021-09-10 Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy Akita, Masayuki Maeda, Eri Nishimura, Tohru Abe, Koichiro Kozuki, Akihito Yokoyama, Kunio Tanaka, Tomohiro Kishi, Shinji Kaneda, Kunihiko BMC Surg Technical Advance BACKGROUND: The aims of the present study were to demonstrate the anatomical change of superior mesenteric vein (SMV) branches and to show how the Cattell Braasch maneuver facilitates a safer ligation of these venous branches during a pancreatoduodenectomy (PD). METHODS: Between January 2010 and December 2019, 97 patients with peripancreatic tumors underwent pancreatectomy. We retrospectively reviewed preoperative triple-phase enhanced computed tomography (CT) images and analyzed variations in SMV branches. Anatomical changes in SMV branches after the Cattell Braasch technique were observed using our operation video and illustrations. RESULTS: The first jejunal vein (J1v) in 75% of patients ran posterior to the superior mesenteric artery (SMA), while the remainder (25%) ran anterior to it. The inferior pancreatoduodenal vein (IPDV) was preoperatively detected in 91% of patients. The IPDV drained into the J1v in 74% of patients and into the SMV in 37%. After the Cattell Braasch maneuver, the J1v which ran posterior to the SMA now was found to lie to the right anterolateral side the SMA and the visualization of both the J1v and the IPDV were much more clearly visualized. CONCLUSIONS: The most frequent venous variation was the IPDV draining into the J1v posterior to the SMA. After the Cattell Braasch maneuver, the IPDV was now located to the right anterolateral anterior aspect of the SMA which facilitates its visualization and should allow a safer ligation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-021-01338-5. BioMed Central 2021-09-08 /pmc/articles/PMC8425086/ /pubmed/34496813 http://dx.doi.org/10.1186/s12893-021-01338-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Technical Advance
Akita, Masayuki
Maeda, Eri
Nishimura, Tohru
Abe, Koichiro
Kozuki, Akihito
Yokoyama, Kunio
Tanaka, Tomohiro
Kishi, Shinji
Kaneda, Kunihiko
Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy
title Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy
title_full Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy
title_fullStr Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy
title_full_unstemmed Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy
title_short Anatomical change of SMV branches after the Cattell Braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy
title_sort anatomical change of smv branches after the cattell braasch maneuver facilitates safe resection around the uncinated process in pancreatoduodenectomy
topic Technical Advance
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425086/
https://www.ncbi.nlm.nih.gov/pubmed/34496813
http://dx.doi.org/10.1186/s12893-021-01338-5
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