Total pancreatectomy
with splenectomy, duodenectomy, and reconstruction of the portal vein with superficial femoral vein graft to two branches of the superior mesenteric vein
00:10 SURGICAL PLANNING
02:19 Exposure
03:20 Mobilize pancreas head
05:26 Mobilize pancreas tail
06:27 Resection
08:56 1st PV-SMV branch reconstruction
Case description
- A 66 year old man was diagnosed with chronic pancreatitis.
- A total pancreatectomy with splenectomy and duodenectomy was proposed, with reconstruction of the portal vein to the largest branches of the SMV using a superficial femoral vein graft.
- There was significant occlusion of the portal vein and superior mesenteric vein posterior to the pancreas, leading to development of collateral branches in and around the pancreas head.
- The right gastric artery, gastroduodenal artery, splenic artery and arterial branches supplying the pancreas will be divided, but the celiac and main SMA will be preserved.
- A replaced right hepatic artery was present, which supplied the pancreas head posteriorly, and will be preserved.
CTs (arterial phase)
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CTs (venous phase)
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