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World Journal of Surgery
Published in: World Journal of Surgery 10/2019

01-10-2019 | Computed Tomography | Original Scientific Report

Benign Portal Vein Stenosis After Pancreaticoduodenectomy

Authors: Katsuhisa Ohgi, Teiichi Sugiura, Yusuke Yamamoto, Yukiyasu Okamura, Takaaki Ito, Ryo Ashida, Takeshi Aramaki, Katsuhiko Uesaka

Published in: World Journal of Surgery | Issue 10/2019

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Abstract

Background

The long-term patency of the portal vein (PV) in patients who survive after pancreaticoduodenectomy (PD) remains unclear. The aim of the present study was to investigate the clinical features and risk factors for benign PV stenosis after PD.

Methods

We retrospectively analyzed the patients who underwent PD from September 2002 and December 2015 at our institution without intraoperative radiation therapy or concomitant PV resection. The postoperative computed tomography of each patient was evaluated, and PV stenosis was defined as the shortest diameter of the PV being <3 mm. The patients with PV stenosis due to local recurrence were excluded.

Results

Of the 458 patients, PV stenosis occurred in 57 (12.4%), including benign PV stenosis in 28 (6.1%) and PV stenosis due to local recurrence in 29 (6.3%). Of the 28 patients with benign PV stenosis, 7 (25%) developed symptoms related to portal hypertension, namely recurrent gastrointestinal bleeding in 5 and refractory ascites in 2. Six patients were treated with percutaneous transhepatic PV stent placement, and all of their symptoms improved. A multivariate analysis found that a postoperative pancreatic fistula was an independent risk factor for benign PV stenosis after PD (odds ratio, 4.36; p = 0.005).

Conclusions

Postoperative pancreatic fistula was a significant risk factor for benign PV stenosis after PD. Stent placement for benign PV stenosis was effective for the patients with symptoms due to portal hypertension.
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Metadata
Title
Benign Portal Vein Stenosis After Pancreaticoduodenectomy
Authors
Katsuhisa Ohgi
Teiichi Sugiura
Yusuke Yamamoto
Yukiyasu Okamura
Takaaki Ito
Ryo Ashida
Takeshi Aramaki
Katsuhiko Uesaka
Publication date
01-10-2019
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 10/2019
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-019-05070-3

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