Open AccessPancreaticoduodenectomy with combined superior mesenteric vein resection without reconstruction is possible: A case report and review of the literature
Author(s) -
Lionel Jouffret,
Théophile Guilbaud,
Olivıer Turrini,
JeanRobert Delpero
Publication year - 2018
Publication title -
world journal of clinical cases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.368
H-Index - 10
ISSN - 2307-8960
DOI - 10.12998/wjcc.v6.i8.214
Subject(s) - medicine , radiology , superior mesenteric vein , pancreaticoduodenectomy , folfirinox , superior mesenteric artery , folfiri , surgery , chemotherapy , pancreas , adenocarcinoma , colorectal cancer , oxaliplatin , portal vein , cancer
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.