Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report
Abstract Background Aggressive surgical resection in locally advanced hepatopancreatobiliary (HPB) malignancies is frequently advocated as the only potentially curative treatment. In recent years, advances in chemotherapy regimens and surgical techniques have led to improved oncologic outcomes and o...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-02995-x |
| _version_ | 1797853823032623104 |
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| author | Rebecca Marino Antonella Tudisco Francesca Ratti Federica Pedica Luca Aldrighetti |
| author_facet | Rebecca Marino Antonella Tudisco Francesca Ratti Federica Pedica Luca Aldrighetti |
| author_sort | Rebecca Marino |
| collection | DOAJ |
| description | Abstract Background Aggressive surgical resection in locally advanced hepatopancreatobiliary (HPB) malignancies is frequently advocated as the only potentially curative treatment. In recent years, advances in chemotherapy regimens and surgical techniques have led to improved oncologic outcomes and overall survival, by increasing the rates of radical (R0) resections. Vascular resections are increasingly reported to further increase disease clearance rates. Within this perspective, the issue of vascular reconstruction has raised growing interest, drawing particular attention to vascular substitutes and surgical techniques for reconstruction. Case presentation A case of extrahepatic cholangiocarcinoma with high clinical suspicion of vascular infiltration of the portal trunk at preoperative assessment is reported. An autologous interposition graft, harvested from diaphragmatic peritoneum, was chosen as a vascular substitute leading to successful portal trunk reconstruction and overcoming all possible drawbacks associated with cadaveric and artificial grafts reconstructions. Conclusion This solution was strategic to ensure complete oncologic clearance averting the risk of positive margins (R1) at final pathology. |
| first_indexed | 2024-04-09T19:55:51Z |
| format | Article |
| id | doaj.art-ed6f097a786a4ebaa75c56a1b2fca205 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-09T19:55:51Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-ed6f097a786a4ebaa75c56a1b2fca2052023-04-03T05:29:21ZengBMCWorld Journal of Surgical Oncology1477-78192023-03-012111810.1186/s12957-023-02995-xTotal portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical reportRebecca Marino0Antonella Tudisco1Francesca Ratti2Federica Pedica3Luca Aldrighetti4Hepatobiliary Surgery Division, IRCCS San Raffaele HospitalHepatobiliary Surgery Division, IRCCS San Raffaele HospitalHepatobiliary Surgery Division, IRCCS San Raffaele HospitalHepatobiliary Surgery Division, IRCCS San Raffaele HospitalHepatobiliary Surgery Division, IRCCS San Raffaele HospitalAbstract Background Aggressive surgical resection in locally advanced hepatopancreatobiliary (HPB) malignancies is frequently advocated as the only potentially curative treatment. In recent years, advances in chemotherapy regimens and surgical techniques have led to improved oncologic outcomes and overall survival, by increasing the rates of radical (R0) resections. Vascular resections are increasingly reported to further increase disease clearance rates. Within this perspective, the issue of vascular reconstruction has raised growing interest, drawing particular attention to vascular substitutes and surgical techniques for reconstruction. Case presentation A case of extrahepatic cholangiocarcinoma with high clinical suspicion of vascular infiltration of the portal trunk at preoperative assessment is reported. An autologous interposition graft, harvested from diaphragmatic peritoneum, was chosen as a vascular substitute leading to successful portal trunk reconstruction and overcoming all possible drawbacks associated with cadaveric and artificial grafts reconstructions. Conclusion This solution was strategic to ensure complete oncologic clearance averting the risk of positive margins (R1) at final pathology.https://doi.org/10.1186/s12957-023-02995-xDistal cholangiocarcinomaPancreaticoduodenectomyGraftParietal peritoneumHepatic surgeryVascular reconstruction |
| spellingShingle | Rebecca Marino Antonella Tudisco Francesca Ratti Federica Pedica Luca Aldrighetti Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report World Journal of Surgical Oncology Distal cholangiocarcinoma Pancreaticoduodenectomy Graft Parietal peritoneum Hepatic surgery Vascular reconstruction |
| title | Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report |
| title_full | Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report |
| title_fullStr | Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report |
| title_full_unstemmed | Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report |
| title_short | Total portal vein replacement with peritoneal interposition graft during Whipple’s procedure for extrahepatic cholangiocarcinoma: a technical report |
| title_sort | total portal vein replacement with peritoneal interposition graft during whipple s procedure for extrahepatic cholangiocarcinoma a technical report |
| topic | Distal cholangiocarcinoma Pancreaticoduodenectomy Graft Parietal peritoneum Hepatic surgery Vascular reconstruction |
| url | https://doi.org/10.1186/s12957-023-02995-x |
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