Portal Venous Reconstruction by Left Renal Venous Grafting for Accidental Portal Vein Injury in During Surgery

Abstract

Autograft portal vein reconstruction is necessary for advanced malignancies extensively invading the portal vein. Left renal venous grafting is one of the useful methods of autograft portal vein reconstruction. The most important advantages of this procedure are: no additional skin incision is needed and harvesting can be performed from the same surgical field. This advantage is highly relevant not only for advanced cancer patients, but also for the so-called “recovery shot”, including control of intraoperative hemorrhage and ensuring adequate blood flow in the case of intraoperative portal veinous accidental injury. In this paper, we outline the advantages and describe the procedural details of left renal venous grafting, and a “recovery shot” case of left renal venous grafting for portal vein reconstruction after massive portal venous injury during pancreaticoduodenectomy.