Reconstruction of the portal vein and the splenic vein in pancreaticoduodenectomy for pancreatic cancer.

BACKGROUND/AIMS: We reconstructed the splenic vein besides the portal vein and/or the superior mesenteric vein after resection of the superior mesenteric-portal vein confluence during pancreaticoduodenectomy for carcinoma of the pancreas and the outcome was retrospectively assessed. METHODOLOGY: Twenty-five patients were classified into three groups. Group O, the splenic vein was left intact (n = 11), Group I, the splenic vein was anastomosed to another vein (n = 6), and Group II, the splenic vein was reconstructed to another vein through autovein graft interposition (n = 8). RESULTS: The patency rate of the superior mesenteric-portal vein anastomosis was 100% in 24 patients evaluated. The blood flow from the splenic vein to the portal vein or another vein was witnessed in 10 patients in Group O, in 3 patients in Group I, and in 7 patients in Group II. CONCLUSIONS: The splenic vein could be reconstructed with high postoperative patency rate, especially in those patients, whose splenic vein was reconstructed using autovein interposition graft.