Resection of the main trunk of the superior mesenteric vein without reconstruction during surgery for giant pancreatic mucinous cystadenoma: A case report

World J Gastroenterol. 2015 Jun 28;21(24):7604-7. doi: 10.3748/wjg.v21.i24.7604.

Abstract

Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein (SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for complete resection of pancreatic tumors. However, the optimum surgical method for venous management is controversial. Resection of the SMV without reconstruction during surgery for pancreatic tumors is rarely reported. Here we present the case of a 58-year-old woman with a giant pancreatic mucinous cystadenoma adhering to the SMV, who underwent an en bloc tumor resection, including the main trunk of the SMV and the spleen. No venous reconstruction was performed during surgery. No ischemic changes occurred in the bowel. The presence of several well-developed collateral vessels was shown by 3-dimensional computed tomography examination. The patient had an uneventful postoperative period and was discharged. This case indicated that the main trunk of the SMV can be resected without venous reconstruction if adequate collateralization has formed.

Keywords: Collateral vessel; Main trunk; Pancreatic mucinous cystadenoma; Reconstruction; Superior mesenteric vein.

Publication types

  • Case Reports

MeSH terms

  • Collateral Circulation
  • Cystadenoma, Mucinous / pathology
  • Cystadenoma, Mucinous / surgery*
  • Female
  • Humans
  • Mesenteric Veins / diagnostic imaging
  • Mesenteric Veins / pathology
  • Mesenteric Veins / physiopathology
  • Mesenteric Veins / surgery*
  • Middle Aged
  • Neoplasm Invasiveness
  • Pancreatectomy*
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / surgery*
  • Splanchnic Circulation
  • Splenectomy
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Tumor Burden*