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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
 
 
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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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