Jouffret L, Guilbaud T, Turrini O, Delpero JR. Pancreaticoduodenectomy with combined superior mesenteric vein resection without reconstruction is possible: A case report and review of the literature. World J Clin Cases 2018; 6(8): 214-218 [PMID: 30148150 DOI: 10.12998/wjcc.v6.i8.214]
Corresponding Author of This Article
Lionel Jouffret, MD, Doctor, Surgical Oncologist, Department of Surgical Oncology, Institut Paoli-Calmettes, 232 Bd de Sainte Marguerite, Marseille 13009, France. jouffretl@ipc.unicancer.fr
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2018; 6(8): 214-218 Published online Aug 16, 2018. doi: 10.12998/wjcc.v6.i8.214
Pancreaticoduodenectomy with combined superior mesenteric vein resection without reconstruction is possible: A case report and review of the literature
Lionel Jouffret, Theophile Guilbaud, Olivier Turrini, Jean-Robert Delpero, Department of Surgical Oncology, Institut PaoliCalmettes, Marseille 13009, France
Author contributions: Jouffret L wrote the manuscript; Guilbaud T drawn the illustration of case report; Turrini O reviewed the manuscript; Delpero JR performed the surgery.
Informed consent statement: Patient authorized publication of case report.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lionel Jouffret, MD, Doctor, Surgical Oncologist, Department of Surgical Oncology, Institut Paoli-Calmettes, 232 Bd de Sainte Marguerite, Marseille 13009, France. jouffretl@ipc.unicancer.fr
Telephone: +33-49-1223660 Fax: +33-49-1223550
Received: March 9, 2018 Peer-review started: March 9, 2018 First decision: April 4, 2018 Revised: April 10, 2018 Accepted: June 7, 2018 Article in press: June 8, 2018 Published online: August 16, 2018
Abstract
We report the case of a 56-year-old woman with pancreatic adenocarcinoma (PA) discovered during an episode of febrile jaundice. A computed tomography (CT) scan showed a mass in the head of the pancreas with circumferential infiltration of the superior mesenteric vein (SMV) and dilatation of the biliary and pancreatic ducts without metastases. The patient benefited from neoadjuvant chemotherapy (FOLFIRINOX) followed by radio-chemotherapy (45 Gy) and chemotherapy (LV5FU2). The revaluation CT revealed SMV thrombosis without portal vein (PV) thrombosis. There was no contact of the tumor with the PV. Pancreatoduodenectomy with combined resection of the SMV was performed with no reconstruction of this venous axis after confirmation of adequate PV, splenic, and left gastric venous flow and the absence of bowel ischemia. The pathological diagnosis was pT4N1R0 PA. There were no bowel angina issues during the follow-up period. At 15 mo after surgery, the patient died of metastatic recurrence.
Core tip: This case report showed that a short superior mesenteric vein resection could be achieved during pancreatoduodenectomy without venous reconstruction, when an appropriate small bowel venous outflow is ensured by inferior mesenteric vein.
