Use of Cold-Stored Vein Allografts for Venous Reconstruction During Pancreaticoduodenectomy
Tóm tắt
Venous resections and reconstructions of portal vein and/or superior mesenteric vein in course of pancreaticoduodenectomy are becoming a common practice and many surgical options have been described, from simple tangential resection and venorrhaphy to large segmental resections followed by interposition grafting. The aim of this study was to report the first experience of using fresh cadaveric vein allografts for venous reconstruction during pancreaticoduodenectomy focusing on technical feasibility and postoperative outcomes. From January 2001 to October 2012, out of 151 patients undergoing pancreaticoduodenectomy for pancreatic head tumor, 22 (14.5 %) received a vascular resection of the mesentericoportal axis. In five of these patients, vascular reconstruction was accomplished by using cold-stored venous allografts of iliac and femoral veins from donor cadaver. Patients’ data, surgical techniques, and clinical outcomes were analyzed. Five patients undergoing pancreaticoduodenectomy were selected to receive a vascular reconstruction using a fresh venous allograft for patch closure in three cases, conduit interposition in one case and a Y-shaped graft in the last case. No graft thrombosis or stenosis occurred postoperatively and at long-term follow-up. Mortality rate was zero. The use of fresh vein allografts is a feasible and effective technique for venous reconstruction during pancreaticoduodenectomy. However, prospective surveys including large cohorts of patients are necessary to confirm these results.
Tài liệu tham khảo
Howard TF, Villanustre N, Moore SA, DeWitt J, LeBlanc J, Maglinte D, McHenry L. Efficacy of venous reconstruction in patients with adenocarcinoma of the pancreatic head. J Gastrointest Surg 2003;7:1089–95
Tseng JF, Raut CP, Lee JE, Pisters PW, Vauthey JN, Abdalla EK, Gomez HF, Sun CC, Crane CH, Wolff RA, Evans DB. Pancreaticoduodenectomy with vascular resection: margin status and survival duration. J Gastrointest Surg 2004;8(8):935-49.
Müller SA, Hartel M, Mehrabi A, Welsch T, Martin DJ, Hinz U, Schmied BM, Büchler MW. Vascular resection in pancreatic cancer surgery: survival determinants. J Gastrointest Surg 2009;13(4):784-92
Yekebas EF, Bogoevski D, Cataldegirmen G, Kunze C, Marx A, Vashist YK, Schurr PG, Liebl L, Thieltges S, Gawad KA, Schneider C, Izbicki JR. En bloc vascular resection for locally advanced pancreatic malignancies infiltrating major blood vessels: perioperative outcome and long-term survival in 136 patients. Ann Surg 2008;247(2):300-9.
van Geenen RC, ten Kate FJ, de Wit LT, van Gulik TM, Obertop H, Gouma DJ. Segmental resection and wedge excision of the portal or superior mesenteric vein during pancreatoduodenectomy. Surgery 2001;129(2):158-63.
Smoot RL, Christein JD, Farnell MB. An innovative option for venous reconstruction after pancreaticoduodenectomy: the left renal vein. J Gastrointest Surg 2007;11(4):425-31.
Fleming JB, Barnett CC, Clagett GP. Superficial femoral vein as a conduit for portal vein reconstruction during pancreaticoduodenectomy. Arch Surg 2005;140(7):698–701.
Chu CK, Farnell MB, Nguyen JH, Stauffer JA, Kooby DA, Sclabas GM, Sarmiento JM. Prosthetic graft reconstruction after portal vein resection in pancreaticoduodenectomy: a multicenter analysis. J Am Coll Surg 2010;211(3):316-24
Ochsner JL, Lawson JD, Eskind SJ, Mills N. Homologous veins as an arterial substitute: long-term results. J Vasc Surg 1984;1:306–313.
Shi XM, Tao YF, Fu ZR, Ding GS, Wang ZX, Xiao L. Reconstruction of the middle hepatic vein tributary in adult right lobe living donor liver transplantation. Hepatobiliary Pancreat Dis Int. 2011;10(6):581-6
Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M, International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005;138(1):8–13.
Wente MN, Veit JA, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, Neoptolemos JP, Padbury RT, Sarr MG, Yeo CJ, Büchler MW. Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery 2007 Jul;142(1):20-5.
Wente MN, Bassi C, Dervenis C, Fingerhut A, Gouma DJ, Izbicki JR, Neoptolemos JP, Padbury RT, Sarr MG, Traverso LW, Yeo CJ, Büchler MW. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 2007;142(5):761–768.
Carrère N, Sauvanet A, Goere D, Kianmanesh R, Vullierme MP, Couvelard A, Ruszniewski P, Belghiti J. Pancreaticoduodenectomy with mesentericoportal vein resection for adenocarcinoma of the pancreatic head. World J Surg. 2006;30(8):1526-35.
Wang F, Arianayagam R, Gill A, Puttaswamy V, Neale M, Gananadha S, Hugh TJ, Samra JS. Grafts for mesenterico-portal vein resections can be avoided during pancreatoduodenectomy. J Am Coll Surg. 2012 Oct;215(4):569-79.
Zhang J, Qian HG, Leng JH, Cui M, Qiu H, Zhou GQ, Wu JH, Yang Y, Hao CY. Long mesentericoportal vein resection and end-to-end anastomosis without graft in pancreaticoduodenectomy. J Gastrointest Surg. 2009 Aug;13(8):1524-8
Adham M, Mirza DF, Chapuis F, Mayer AD, Bramhall SR, Coldham C, Baulieux J, Buckels J. Results of vascular resections during pancreatectomy from two European centres: an analysis of survival and disease-free survival explicative factors. HPB (Oxford). 2006;8(6):465-73.
Kuang AA, Renz JF, Ferrell LD, Ring EJ, Rosenthal P, Lim RC, Roberts JP, Ascher NL, Emond JC. Failure patterns of cryopreserved vein grafts in liver transplantation. Transplantation 1996;62:742-747.
Maluf MA, Carvalho AC, Carvalho WB. Use of right ventricular remodeling surgery with a porcine pulmonary prosthesis for congenital heart disease. Heart Surg Forum. 2011;14(1):E40-50
Boethig D, Thies WR, Hecker H, Breymann T. Mid term course after pediatric right ventricular outflow tract reconstruction: a comparison of homografts, porcine xenografts and Contegras. Eur J Cardiothorac Surg 2005;27(1):58-66
Yoshioka M, Onda M, Tajiri T, Akimaru K, Mineta S, Hirakata A, Takubo K. Reconstruction of the portal vein using a peritoneal patch-graft. Am J Surg. 2001;181(3):247-50.
Galambos B, Oláh A, Banga P, Csönge L, Almási J, Acsády G. Successful human vascular reconstructions with long-term refrigerated venous homografts. Eur Surg Res 2009;43(3):256-61
Smoot RL, Christein JD, Farnell MB. Durability of portal venous reconstruction following resection during pancreaticoduodenectomy. J Gastrointest Surg. 2006;10(10):1371-5.
Leach SD, Lee JE, Charnsangavej C, Cleary KR, Lowy AM, Fenoglio CJ, Pisters PW, Evans DB. Survival following pancreaticoduodenectomy with resection of the superior mesenteric-portal vein confluence for adenocarcinoma of the pancreatic head. Br J Surg 1998;85(5):611-7.
Ouaïssi M, Sielezneff I, Pirro N, Bon Mardion R, Chaix JB, Merad A, Berdah S, Moutardier V, Cresti S, Emungania O, Anderson L, Christian B, Bernard S. Therapeutic anticoagulant does not modify thromboses rate vein after venous reconstruction following pancreaticoduodenectomy. Gastroenterol Res Pract 2008;2008:896320.
Matia I, Varga M, Lodererova A, Adamec M. The positive effect of immunosuppression on adaptation of venous allografts to arterialisation in rats. Eur J Vasc Endovasc Surg. 2010;39(4):478-84.
Guerrero MA, Cross CA, Lin PH, Keane TE, Lumsden AB. Inferior vena cava reconstruction using fresh inferior vena cava allograft following caval resection for leiomyosarcoma: midterm results. J Vasc Surg. 2007;46(1):140-3
Hwang S, Ha TY, Jung DH, Park JI, Lee SG. Portal vein interposition using homologous iliac vein graft during extensive resection for hilar bile duct cancer. J Gastrointest Surg 2007;11(7):888-92
Piselli P, Serraino D, Segoloni GP, Sandrini S, Piredda GB, Scolari MP, Rigotti P, Busnach G, Messa P, Donati D, Schena FP, Maresca MC, Tisone G, Veroux M, Sparacino V, Pisani F, Citterio F; Immunosuppression and Cancer Study Group. Risk of de novo cancers after transplantation: results from a cohort of 7217 kidney transplant recipients, Italy 1997–2009. Eur J Cancer. 2013;49(2):336-44