Pancreatico-duodonectomy (Whipple Procedure)
With reconstruction of SMA using saphenous vein jump graft, reconstruction of SMV, and reconstruction of splenic vein using left renal vein graft
Chapter 1: Surgical Planning
Chapter 2: Evaluation of SMA & SMV
Chapter 3: Saphenous vein and left renal vein harvest
Chapter 4: SMA reconstruction: jump graft from aorta
Chapter 5: Duodenal and proximal jejunum division
Chapter 6: Pancreas and splenic vein transection
Chapter 7: SMA & SMV resection and reconstruction
Chapter 8: Splenic vein reconstruction
Chapter 9: Pancreaticojejunostomy
Chapter 10: Choledochojejunostomy and Duodenojejunostomy
- 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 .