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
03:20 Mobilize pancreas head
05:26 Mobilize pancreas tail
- 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)
CTs (venous phase)