Interposition graft with polytetrafluoroethylene for mesenteric and portal vein reconstruction after pancreaticoduodenectomy.

Abstract

Portal vein-superior mesenteric vein resection is frequently required after surgical resection of tumours of the pancreas head. The ideal graft for portal vein reconstruction (PVR) remains undefined. Between May 2000 and July 2007, 28 patients had portal vein-superior mesenteric vein resection and PVR during pancreaticoduodenectomy. Their clinical reports were reviewed retrospectively with specific attention to the methods of PVR and outcomes. Ten patients had PVR with primary anastomosis, seven had PVR with autologous vein, one had a polytetrafluoroethylene (PTFE) patch, one did not have PVR and nine had PVR with a PTFE interposition graft. There was no infection after PTFE grafting. Six patients had PVR thrombosis after surgery: four after primary anastomosis, one after interposition PTFE and one after vein repair. PTFE appeared to be an effective and safe option as an interposition graft for portomesenteric venous reconstruction after pancreaticoduodenectomy.