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Surgical pitfalls of jejunal vein anatomy in pancreaticoduodenectomy
Author(s) -
Ishikawa Yoshiya,
Ban Daisuke,
Matsumura Satoshi,
Mitsunori Yusuke,
Ochiai Takanori,
Kudo Atsushi,
Tanaka Shinji,
Tanabe Minoru
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.451
Subject(s) - pancreaticoduodenectomy , medicine , superior mesenteric artery , sma* , trunk , vein , anatomy , superior mesenteric vein , radiology , gross anatomy , pancreatic head , portal vein , pancreas , surgery , biology , computer science , ecology , algorithm
Background Pancreaticoduodenectomy ( PD ) is the standard surgical procedure for treating pancreatic head cancers. Considerable knowledge of proximal jejunal and pancreatic vein anatomy is a prerequisite for performing PD surgery safely, yet there appear to be no detailed descriptions of first and second jejunal vein (J1V, J2V) anatomy available in the literature. Study design Adults with hepatobiliary‐pancreatic disease underwent multidetector‐row computed tomography with intravenous contrast ( n = 155), and SYNAPSE 3D (Fujifilm Medical, Tokyo, Japan) was used to generate 3D‐ CT images. Results In 84% of patients, J1V and J2V formed a common trunk ( FJT ). There were three patterns of branches, related to the presence or absence of FJT formation and the anatomical relationships between the superior mesenteric artery ( SMA ) and the jejunal veins, as follows: Type 1 ( n = 98, 63%) characterized by an FJT located dorsal to SMA ; Type 2 ( n = 32, 21%), where the FJT was located ventral to the SMA ; and Type 3 ( n = 25, 16%), where J1V and J2V each drained separately into the SMV . Conclusions J1V and J2V usually formed an FJT , and separate J1V and J2V drainage into the SMV was uncommon. Preoperative information on individual patient venous anatomy would increase the safety of the PD procedure.