2020 Volume 45 Issue 2 Pages 146-153
The patient was a 61-year-old male who was referred to our hospital. Abdominal dynamic CT revealed an unclear lesion measuring about 20 mm in diameter in the head of the pancreas, which was in contact with the superior mesenteric vein at an angle of about 90 degrees, but no deformation of the blood vessel was observed. The patient was diagnosed as having pancreatic head cancer (cT3cN0cM0 cStage ⅡA, Resectability: Resectable), and we planned treatment by surgery. A subtotal stomach-preserving pancreatoduodenectomy (D2 dissection) with portal vein resection, including the splenic vein junction, was performed. In order to reconstruct the splenic vein, it was detached from the pancreas about 50 mm from the junction. The splenic vein was cut at the junction, and the central end of the splenic vein was anastomosed to the anterior wall of the left renal vein. The blood vessel anastomosis time was 24 minutes, and the time required for reconstruction was about one hour, including the release of both blood vessels. The postoperative course was satisfactory, and the patient was discharged with no thrombocytopenia. No signs of left portal hypertension, such as splenomegaly or thrombosis, have been found in the patient after discharge.
