Pancreaticoduodenectomy (Whipple Procedure)
With reconstruction of SMA using saphenous vein jump graft, reconstruction of SMV, and reconstruction of splenic vein using left renal vein graft
00:08 Surgical Planning
01:47 Evaluation of SMA & SMV
05:15 Saphenous vein and left renal vein harvest
06:12 SMA reconstruction: jump graft from aorta
07:06 Duodenal and proximal jejunum division
07:30 Pancreas and splenic vein transection
08:39 SMA & SMV resection and reconstruction
10:17 Splenic vein reconstruction
11:28 Pancreaticojejunostomy
Case description
- A tumour was found in the neck of the pancreas of a 62-year-old women. The tumour enveloped the SMA at its root and also pushed against the SMV wall.
- A pylorus preserving pancreaticoduodenectomy was proposed along with resection of SMA and SMV.
- The transection margin of the pancreas was far to the left of the portal vein and neck of the pancreas.
- The SMA was reconstructed with a saphenous vein jump graft that runs from the aorta to the divided SMA.
- A SMV to portal vein end-to-end anastomosis was performed and a left renal vein graft was used to reconstruct the splenic vein. This was followed by pancreaticojejunostomy with the use of a pancreatic stent.
- An in-depth video of the pancreaticojejunostomy technique used in this video can be found here .
CT scans
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