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1

Dzidzava, Iliya I., Ivan V. Gayvoronsky, Andrei B. Kotiv, and Sergey A. Alentyev. "The topographo-anatomical conditions of reconstruction of the trunk and roots of the portal vein during gastropancreatoduodenal resection." Bulletin of the Russian Military Medical Academy 23, no. 1 (May 12, 2021): 33–40. http://dx.doi.org/10.17816/brmma60216.

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Topographic and anatomical variants of vascular plastics in extended gastropancreatoduodenal resection are substantiated. The anatomical study was performed on 30 organ complexes and 5 not embalmed human corpses. Significant variability of the roots and tributaries of the v. portae and their location near the pancreas was revealed. The extended contact of the mesenteric-portal segment with the head of the pancreas promotes the involvement of the veins of the portal system in the tumor process. The magistral type of the structure of the superior mesenteric vein was revealed in 19 cases, the distributed type in 11, which determines the conditions for vascular reconstruction. In the experiment the possibility of creation the formation of the direct mesenteric-portal anastomosis after duodenectomy was established in case of shifting the mobilized root of the mesentery of the small intestine in the direction of the liver gate. If splenic vein resection is necessary, adequate blood outflow from the stomach, spleen, and pancreatic stump can be provided by forming a distal splenic-renal anastomosis or, with a sufficient length of the splenic vein, a splenic-portal anastomosis. Based on computed tomography angiographs and intraoperative data 29 patients underwent extended gastropancreatoduodenal resection followed by vascular reconstruction. Tumor invasion of the trunk of the portal vein on computed tomography angiograms was represented by offset and the contact of the tumor with portal vein for over 10 mm (in 7 cases), the displacement and deformation of the portal vein tumor (in 5 cases), tumor infiltration of more than 50% of the circumference of the portal vein (in 3 cases). Extended contact with the tumor was identified in 9 cases, confluence stenosis of the portal vein in 5 cases. The tumor invasion into the portal vein, and the vascular system was restored by the formation of a port-portal anastomosis in 15 cases. Moreover at the reconstruction of mesenteric-portal segment we formed mesenteric-portal anastomosis in 10 cases. Also in 2 cases mesenteric-portal anastomosis in the confluence area of the iliac colon and jejunum tributaries was formed, in 1 case we formed anastomosis between the ileum-colon vein and the portal vein (with 1:2 diameter difference without patency disorders). In one single case we connected iliac colon vein wall with jejunum vein wall and formed anastomosis between them and portal vein. Distal splenorenal anastomosis was formed in 10 patients from this group. Spleno-portal anastomosis was formed in 3 patients above the junction of the portal and superior mesenteric veins.
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2

Jara, Maximilian, Maciej Malinowski, Marcus Bahra, Martin Stockmannn, Antje Schulz, Johann Pratschke, and Gero Puhl. "Bovine Pericardium for Portal Vein Reconstruction in Abdominal Surgery: A Surgical Guide and First Experiences in a Single Center." Digestive Surgery 32, no. 2 (2015): 135–41. http://dx.doi.org/10.1159/000370008.

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Background: Resection and reconstruction of infiltrated vessels achieve resectability of extended pancreatic tumors. The aim of the present study was to assess the feasibility of bovine pericardium as graft material for the individualised portal vein reconstruction and demonstrate a surgical technique for abdominal vein repair. Methods: We performed a MEDLINE search to review the methods for complex abdominal vein reconstruction in the course of extended pancreatectomy. Moreover, clinical data of patients receiving portal vein reconstruction using a bovine pericardial patch at our institution were retrospectively analyzed. Results: Based on the results of a review of the literature, autologous venous grafts using the internal jugular vein represent the most popular option for segmental portal vein reconstruction in case of impossible direct suture. At our center, segmental portal vein reconstruction with bovine pericardial patch in course of pancreatic surgery was performed in 4 patients. No case of vascular complications such as occlusion, segmental stenosis or thrombosis occurred. Conclusions: Our experience suggests a surgical procedure for an individual size-matched portal vein reconstruction using bovine pericardium. Although first results appear promising, prospective studies are required to objectively assess the patency of bovine pericardium compared with autologous and synthetic interposition grafts for portal vein reconstruction.
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3

Zahlten, Cornelia, H. Jürgens, C. J. G. Evertsz, R. Leppek, H. O. Peitgen, and K. J. Klose. "Portal vein reconstruction based on topology." European Journal of Radiology 19, no. 2 (January 1995): 96–100. http://dx.doi.org/10.1016/0720-048x(94)00578-z.

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4

Angelico, Roberta, Bruno Sensi, Alessandro Parente, Leandro Siragusa, Carlo Gazia, Giuseppe Tisone, and Tommaso Maria Manzia. "Vascular Involvements in Cholangiocarcinoma: Tips and Tricks." Cancers 13, no. 15 (July 25, 2021): 3735. http://dx.doi.org/10.3390/cancers13153735.

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Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract. To date, surgical treatment remains the only hope for definitive cure of CCA patients. Involvement of major vascular structures was traditionally considered a contraindication for resection. Nowadays, selected cases of CCA with vascular involvement can be successfully approached. Intrahepatic CCA often involves the major hepatic veins or the inferior vena cava and might necessitate complete vascular exclusion, in situ hypothermic perfusion, ex situ surgery and reconstruction with autologous, heterologous or synthetic grafts. Hilar CCA more frequently involves the portal vein and hepatic artery. Resection and reconstruction of the portal vein is now considered a relatively safe and beneficial technique, and it is accepted as a standard option either with direct anastomosis or jump grafts. However, hepatic artery resection remains controversial; despite accumulating positive reports, the procedure remains technically challenging with increased rates of morbidity. When arterial reconstruction is not possible, arterio-portal shunting may offer salvage, while sometimes an efficient collateral system could bypass the need for arterial reconstructions. Keys to achieve success are represented by accurate selection of patients in high-volume referral centres, adequate technical skills and eclectic knowledge of the various possibilities for vascular reconstruction.
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5

Parmentier de León, Catherine, Paulina Carpinteyro Espin, Marco J. Quintero Quintero, Rodrigo Cruz Martínez, and Mario Vilatoba. "Ovarian Vein to Portal Vein Reconstruction: Another Option in Liver Transplant With Portal Vein Thrombosis." Experimental and Clinical Transplantation 19, no. 8 (August 2021): 877–79. http://dx.doi.org/10.6002/ect.2020.0429.

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6

Teixeira, Uirá Fernandes, Mayara Christ Machry, Marcos Bertozzi Goldoni, Cristine Kruse, João Alfredo Diedrich, Pablo Duarte Rodrigues, Caroline Becker Giacomazzi, et al. "Use of Left Gastric Vein as an Alternative for Portal Flow Reconstruction in Liver Transplantation." Case Reports in Surgery 2016 (2016): 1–4. http://dx.doi.org/10.1155/2016/8289045.

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Portal vein thrombosis is observed in up to 10% of liver transplant candidates, hindering execution of the procedure. A dilated gastric vein is an alternative to portal vein reconstruction and decompression of splanchnic bed. We present two cases of patients with portal cavernoma and dilated left gastric vein draining splanchnic bed who underwent liver transplantation. The vein was dissected and sectioned near the cardia; the proximal segment was ligated with suture and the distal segment was anastomosed to the donor portal vein. Gastroportal anastomosis is an excellent option for portal reconstruction in the presence of thrombosis or hypoplasia. It allows an adequate splanchnic drainage and direction of hepatotrophic factors to the graft.
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7

Glebova, Natalia O., Caitlin W. Hicks, Kristine C. Orion, Christopher J. Abularrage, Matthew J. Weiss, Andrew M. Cameron, Christopher L. Wolfgang, and James H. Black. "Portal Vein Reconstruction in Pancreatic Resection: Technical Risk Factors for Portal Vein Thrombosis◊." Journal of Vascular Surgery 60, no. 3 (September 2014): 831–32. http://dx.doi.org/10.1016/j.jvs.2014.06.076.

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8

Flis, Vojko, Stojan Potrc, Nina Kobilica, and Arpad Ivanecz. "Pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head with venous resection." Radiology and Oncology 50, no. 3 (September 1, 2016): 321–28. http://dx.doi.org/10.1515/raon-2015-0017.

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Abstract Background Recent reports have shown that patients with vascular tumour invasion who undergo concurrent vascular resection can achieve long-term survival rates equivalent to those without vascular involvement requiring pancreaticoduodenectomy alone. There is no consensus about which patients benefit from the portal-superior mesenteric vein resection and there is no consensus about the best surgical technique of vessel reconstruction (resection with or without graft reconstruction). As published series are small the aim of this study was to evaluate our experience in pancreatectomies with en bloc vascular resection and reconstruction of vessels. Methods Review of database at University Clinical Centre Maribor identified 133 patients (average age 65.4 ± 8.6 years, 69 female patients) who underwent pancreatoduodenectomy between January 2006 and August 2014. Clinical data, operative results, pathological findings and postoperative outcomes were collected prospectively and analyzed. Current literature and our experience in pancreatectomies with en bloc vascular resection and reconstruction of portal vein are reviewed. Results Twenty-two patients out of 133 (16.5%) had portal vein-superior mesenteric vein resection and portal vein reconstruction (PVR) during pancreaticoduodenectomy. In fourteen patients portal vein was reconstructed without the use of synthetic vascular graft. In these series two types of venous reconstruction were performed. When tumour involvement was limited to the superior mesenteric vein (SPV) or portal vein (PV) such that the splenic vein could be preserved, and vessels could be approximated without tension a primary end-to-end anastomosis was performed. When tumour involved the SMV-splenic vein confluence, splenic vein ligation was necessary. In the remaining eight procedures interposition graft was needed. Dacron grafts with 10 mm diameter were used. There was no infection after dacron grafting. One patient had portal vein thrombosis after surgery: it was thrombosis after primary reconstruction. There were no thromboses in patients with synthetic graft interposition. There were no significant differences in postoperative morbidity, mortality or grades of complication between groups of patients with or without a PVR. Median survival time in months was in a group with vein resection 16.13 months and in a group without vein resection 15.17 months. Five year survival in the group without vein resection was 19.5%. Comparison of survival curves showed equal hazard rates with log-rank p = 0.090. Conclusions Survival of patients with pancreatic cancer who undergo an R0 resection with reconstruction was comparable to those who have a standard pancreaticoduodenectomy with no added mortality or morbidity. Synthetic graft appeared to be an effective and safe option as an interposition graft for portomesenteric venous reconstruction after pancreaticoduodenectomy.
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9

Amico, Enio Campos, José Roberto Alves, and Samir Assi João. "Splenic vein graft for the reconstruction of the mesenteric-portal trunk after gastroduodenopancreatectomy." Revista do Colégio Brasileiro de Cirurgiões 41, no. 5 (October 2014): 381–83. http://dx.doi.org/10.1590/0100-69912014005015.

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Resection of the confluence of the superior mesenteric and portal veins has been performed most frequently in the treatment of adenocarcinoma of the pancreas, in view of the reported positive results, but it can also be used in cases of benign pancreatic neolpasias when they are strongly adhered to the mesenteric-portal trunk. Nevertheless, there is no study on the best type of venous grafts for reconstruction of the mesenteric-portal trunk when required. The choice of graft depends on the preference of the surgeon or the institution. This technical note critically discusses the use of the splenic vein as an option for mesenteric-portal trunk reconstruction after gastroduodenopancreatectomy.
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10

Yang, Zhe, Shuo Wang, Jan Lerut, Li Zhuang, and Shusen Zheng. "Portal inflow reconstruction for liver transplantation with portal vein thrombosis." Hepatobiliary Surgery and Nutrition 10, no. 2 (April 2021): 291–94. http://dx.doi.org/10.21037/hbsn-20-797.

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11

Tanaka, Masayuki, Hiromichi Ito, Yoshihiro Ono, Kiyoshi Matsueda, Yoshihiro Mise, Takeaki Ishizawa, Yosuke Inoue, et al. "Impact of portal vein resection with splenic vein reconstruction after pancreatoduodenectomy on sinistral portal hypertension: Who needs reconstruction?" Surgery 165, no. 2 (February 2019): 291–97. http://dx.doi.org/10.1016/j.surg.2018.08.025.

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12

Rhu, Jinsoo, Gyu‐Seong Choi, Choon Hyuck David Kwon, Jong Man Kim, and Jae‐Won Joh. "Portal vein thrombosis during liver transplantation: The risk of extra‐anatomical portal vein reconstruction." Journal of Hepato-Biliary-Pancreatic Sciences 27, no. 5 (April 3, 2020): 242–53. http://dx.doi.org/10.1002/jhbp.711.

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13

Oh, Jongwook, Jinsoo Rhu, Gyu Seong Choi, Jong Man Kim, Jae-Won Joh, Sang Jin Kim, Seohee Lee, Jiyoung Hong, Kyeongdoek Kim, and Okjoo Lee. "Portal vein thrombosis during liver transplantation: The risk of extra-anatomical portal vein reconstruction." HPB 21 (2019): S479. http://dx.doi.org/10.1016/j.hpb.2019.10.2307.

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14

Kostov, Gancho, and Rossen Dimov. "Portal vein reconstruction during pancreaticoduodenal resection using an internal jugular vein as a graft." Folia Medica 63, no. 3 (June 30, 2021): 429–32. http://dx.doi.org/10.3897/folmed.63.e55650.

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Portal vein involvement by malignant tumours of the head of the pancreas is observed in almost 50% of the patients. In the past, this finding usually rendered the tumor inoperable. Over the past 30 years, the operative morbidity and mortality rate of pancreatectomy combined with portal vein resection has greatly decreased, and portal vein resection in pancreatic surgery has become a well-tolerated operative procedure in large-volume centres. Options for a venous reconstruction after SMV/PV resection include prosthetic, autologous or cryopreserved cadaveric vein grafts.Vascular resection and reconstruction provides great opportunity for R0 resection and improvement of oncological results in patients with pancreatic tumors and involvement of venous vessels, in the absence of distant metastases. If a longer graft length is required, there is the option of using either synthetic prosthesis or cryopreserved grafts. Their weak sides can be avoided by the use of jugular vein graft. Portal vein resection will be performed more often, safely and aggressively over the next years.
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15

Tashiro, Hirotaka, Toshiyuki Itamoto, Hironobu Amano, Akihiko Oshita, Hideki Ohdan, and Toshimasa Asahara. "Portal vein reconstruction using explanted recipient's native right hepatic vein." Surgery 144, no. 1 (July 2008): 105. http://dx.doi.org/10.1016/j.surg.2008.04.003.

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16

Prakash, Kurumboor, Jean-Marc Regimbeau, and Jacques Belghiti. "Reconstruction of portal vein using a hepatic vein patch graft after combined hepatectomy and portal vein resection." American Journal of Surgery 185, no. 3 (March 2003): 230–31. http://dx.doi.org/10.1016/s0002-9610(02)01360-0.

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17

Fan, Ji-Long, Cheng Lu, Xing-Long Dai, Xian Liu, Hao Ma, Hai-Feng Li, Kai Lin, et al. "Feasibility of bile duct as venous graft for venous reconstruction in pancreatic surgery: An animal experimental study." Vascular 28, no. 4 (March 2, 2020): 450–56. http://dx.doi.org/10.1177/1708538120902653.

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Objective Pancreatic cancer is a kind of high malignant tumor with a poor prognosis. The aim is to determine whether the dilated bile duct can be used to reconstruct the vessels. Methods An animal model of jugular vein and portal vein reconstruction was established using the bile duct. A total of 20 landrace pigs were selected to undergo jugular vein reconstruction or portal vein reconstruction using the bile duct as a patch or bridge. The patency was evaluated by color Doppler, the reconstructed segments were removed and examined macroscopically and histologically at specified intervals, and the results were compared with synthetic vessels (IMPRA straight, 10s03-19). Results The lumen was patent, although a low level thrombosis was observed when jugular or portal vein patching was used. For bridging, stenosis of the lumen was observed, and necrosis appeared when the bile duct was used for bridging, indicating that it is feasible to reconstruct the jugular vein and portal vein with a bile duct patch. However, the bridge was not feasible possibly due to loss of blood supply, and consequent necrosis and fibrosis. Conclusion The bile duct is technically feasible, but the outcomes are unsatisfactory.
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18

Worrest, Tarin, Elizabeth Dewey, Patrick J. Worth, Erin Gilbert, and Brett C. Sheppard. "960 - Recurrence Patterns and Survival Following Pancreaticoduodenectomy with Portal Vein Reconstruction Compared to Patients not Requiring Portal Vein Reconstruction." Gastroenterology 154, no. 6 (May 2018): S—1297—S—1298. http://dx.doi.org/10.1016/s0016-5085(18)34253-7.

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19

Rong Xiu, Dian, Shuuji Hishikawa, Munekatu Sato, Hideo Nagai, Hiroo Uchida, and Eiji Kobayashi. "Rat auxiliary liver transplantation without portal vein reconstruction: Comparison with the portal vein-arterialized model." Microsurgery 21, no. 5 (2001): 189–95. http://dx.doi.org/10.1002/micr.1037.

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20

Mitchell, Andrew, P. R. John, D. A. Mayer, D. F. Mirza, J. A. C. Buckels, and Jean de Ville de Goyet. "Improved technique of portal vein reconstruction in pediatric liver transplant recipients with portal vein hypoplasia." Transplantation 73, no. 8 (April 2002): 1244–47. http://dx.doi.org/10.1097/00007890-200204270-00009.

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21

Uchida, Hajime, Seisuke Sakamoto, Takanobu Shigeta, Ikumi Hamano, Hiroyuki Kanazawa, Akinari Fukuda, Chiaki Karaki, Atsuko Nakazawa, and Mureo Kasahara. "Living Donor Liver Transplantation with Renoportal Anastomosis for a Patient with Congenital Absence of the Portal Vein." Case Reports in Surgery 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/670289.

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A congenital absence of the portal vein (CAPV) is a rare disorder that may lead to an intrapulmonary shunt. A 14-year-old male with CAPV underwent living donor liver transplantation with a left lobe graft from his father. The portal vein reconstruction was achieved with a renoportal anastomosis using an interpositional graft from the native collateral vein, because portal venous system directly drains to the left renal vein without constructing the confluence of superior mesenteric vein and splenic vein. The patient is doing well with a normal liver function and mild hypoxemia.
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22

Matsui, J., and Y. Takigawa. "Portal vein reconstruction using an autologous splenic vein graft at the superior mesenteric and portal vein confluence during pancreaticoduodenectomy." HPB 20 (September 2018): S829. http://dx.doi.org/10.1016/j.hpb.2018.06.1819.

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23

Hemming, Alan W., Robin D. Kim, Kristin L. Mekeel, Shiro Fujita, Alan I. Reed, David P. Foley, and Richard J. Howard. "Portal Vein Resection for Hilar Cholangiocarcinoma." American Surgeon 72, no. 7 (July 2006): 599–605. http://dx.doi.org/10.1177/000313480607200706.

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Hilar cholangiocarcinoma remains a difficult challenge for the surgeon. Achieving negative surgical margins when resecting this relatively uncommon tumor is technically demanding as a result of the close proximity of the bile duct bifurcation to the vascular inflow of the liver. A recent advance in surgical treatment is the addition of portal vein resection to the procedure. Resection of the portal vein increases the number of patients offered a potentially curative approach but is technically more difficult and may increase the risk of the procedure. This study reviews the results of portal vein resection for hilar cholangiocarcinoma. Between 1998 and 2005, 60 patients underwent potentially curative resections of hilar cholangiocarcinoma. Mean patient age was 64 ± 12 years (range, 24–85 years). Liver resections performed along with biliary resection included 49 trisegmentectomies (37 right, 12 left) and 10 lobectomies (8 left, 2 right). One patient had only the bile duct resected. Four patients also had simultaneous pancreaticoduodenectomy performed. Twenty-six patients required portal vein resection and reconstruction to achieve negative margins, 3 of which also required reconstruction of the hepatic artery. Operative mortality was 8 per cent with an overall complication rate of 40 per cent. Patients who underwent portal vein resection had an operative mortality of 4 per cent, which was not different from the 12 per cent mortality in patients who did not undergo portal vein resection (P = 0.39). There was no difference in actuarial patient survival between patients who underwent portal vein resection and those who did not (5-year survival 39 per cent vs. 41 per cent, P = not significant). Negative margins were achieved in 80 per cent of cases and were associated with improved survival (P < 0.01). Five-year actuarial survival in patients undergoing resection with negative margins was 45 per cent. There was no difference in margin status or long-term survival between those patients who underwent portal vein resection and those who did not. Only negative margin status was associated with improved survival by multivariate analysis. Portal vein resection for hilar cholangiocarcinoma is safe and allows a chance for long-term survival in otherwise unresectable patients.
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Chiu, Kuan-Ming, Shu-Hsun Chu, Jer-Shen Chen, Shao-Jung Li, Chih-Yang Chan, and Kuo-Shin Chen. "Spiral Saphenous Vein Graft for Portal Vein Reconstruction in Pancreatic Cancer Surgery." Vascular and Endovascular Surgery 41, no. 2 (April 2007): 149–52. http://dx.doi.org/10.1177/1538574406297259.

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25

Fleming, Jason B. "Superficial Femoral Vein as a Conduit for Portal Vein Reconstruction During Pancreaticoduodenectomy." Archives of Surgery 140, no. 7 (July 1, 2005): 698. http://dx.doi.org/10.1001/archsurg.140.7.698.

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Umemura, Akira, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Hirokatsu Katagiri, Shoji Kanno, Megumi Kobayashi, Taro Ando, Taku Kimura, and Akira Sasaki. "Portal bifurcation reconstruction using own hepatic vein grafts due to portal vein anomaly of the living donor for the patient with portal vein thrombosis." Annals of Hepato-Biliary-Pancreatic Surgery 24, no. 4 (November 30, 2020): 533–38. http://dx.doi.org/10.14701/ahbps.2020.24.4.533.

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27

Teng, Fei, Ke-Yan Sun, and Zhi-Ren Fu. "Tailored classification of portal vein thrombosis for liver transplantation: Focus on strategies for portal vein inflow reconstruction." World Journal of Gastroenterology 26, no. 21 (June 7, 2020): 2691–701. http://dx.doi.org/10.3748/wjg.v26.i21.2691.

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28

Kuramitsu, Kaori, Takumi Fukumoto, Hisoka Kinoshita, Masahiro Kido, Atsushi Takebe, Motofumi Tanaka, Takeshi Iwasaki, Masahiro Tominaga, and Yonson Ku. "Analysis of Portal Vein Reconstruction Technique with High-Grade Portal Vein Thrombus in Living Donor Liver Transplantation." Annals of Transplantation 21 (June 21, 2016): 380–85. http://dx.doi.org/10.12659/aot.897958.

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29

Salsamendi, Jason T., Francisco J. Gortes, Michelle Shnayder, Mehul H. Doshi, Ji Fan, and Govindarajan Narayanan. "Transsplenic portal vein reconstruction–transjugular intrahepatic portosystemic shunt in a patient with portal and splenic vein thrombosis." Radiology Case Reports 11, no. 3 (September 2016): 186–89. http://dx.doi.org/10.1016/j.radcr.2016.05.014.

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Miyazaki, Masaru, Hiroaki Shimizu, Masayuki Ohtuka, Atsushi Kato, Hiroyuki Yoshitomi, Katsunori Furukawa, Tsukasa Takayashiki, et al. "Portal vein thrombosis after reconstruction in 270 consecutive patients with portal vein resections in hepatopancreatobiliary (HPB) surgery." American Journal of Surgery 214, no. 1 (July 2017): 74–79. http://dx.doi.org/10.1016/j.amjsurg.2016.12.008.

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Rahayatri, Tri Hening, Harsya Dwindaru Gunardi, Rusdah Binti Muhammad Amin, Damayanti Sekarsari, Marini Stephanie, Sastiono Soedibyo, Seisuke Sakamoto, and Mureo Kasahara. "Pediatric living donor liver transplantation with non-anatomical portal vein reconstruction in idiopathic extrahepatic portal vein thrombosis." Journal of Pediatric Surgery Case Reports 59 (August 2020): 101510. http://dx.doi.org/10.1016/j.epsc.2020.101510.

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32

Fong, Tse-Ling, Michael Fong, Jerold Shinbane, Vaughn Starnes, and Helga Van Herle. "Late onset cardiac cirrhosis and portal hypertensive ascites after atrial fibrillation ablation." Pulmonary Circulation 9, no. 1 (November 13, 2018): 204589401881355. http://dx.doi.org/10.1177/2045894018813559.

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Pulmonary vein stenosis is a potential complication following catheter ablation of atrial fibrillation (AF). We report the case of a patient with refractory ascites late after multiple catheter ablation procedures for AF. This is the first case report of portal hypertensive ascites due to acquired multiple pulmonary vein stenoses resulting in pulmonary hypertension (PH) and cardiac cirrhosis late after AF ablation. Despite extensive surgical reconstruction of the affected pulmonary veins, the patient has PH and right heart failure with persistent ascites and lower extremity edema.
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33

Levi, David M., Danny Sleeman, Evangelos P. Misiakos, and Andreas G. Tzakis. "Reconstruction of the Portal Vein During a Whipple Pancreaticoduodenectomy." European Journal of Surgery 168, no. 7 (October 1, 2002): 422–24. http://dx.doi.org/10.1080/110241502320789122.

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34

Li, Xiangcheng. "Right Hepatectomy with Portal Vein Reconstruction for Hilar Cholangiocarcinoma." HPB 21 (2019): S220. http://dx.doi.org/10.1016/j.hpb.2019.10.1616.

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Herrero, Astrid, Regis Souche, Fabrizio Panaro, and Francis Navarro. "Endovascular balloon occlusion during reconstruction of portal vein injury." Langenbeck's Archives of Surgery 405, no. 3 (May 2020): 391–95. http://dx.doi.org/10.1007/s00423-020-01886-z.

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36

Li, Xiangcheng, Feng Qinchao, Wu Zhengshan, and Li Changxian. "Left hepatectomy with portal vein reconstruction for hilar cholangiocarcinoma." HPB 21 (2019): S519. http://dx.doi.org/10.1016/j.hpb.2019.10.2428.

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37

Burkert, B., Ph Regeniter, A. Mumme, T. Hummel, and D. Mühlberger. "Previous vena cava occlusion as the cause of a bilateral iliofemoral thrombosis." Phlebologie 45, no. 05 (September 2016): 322–24. http://dx.doi.org/10.12687/phleb2323-5-2016.

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SummaryA case of bilateral iliofemoral thrombosis in a 17-year-old [male] patient is presented. It was only revealed during bilateral transfemoral thrombectomy that the thrombosis was due to previous inferior vena cava occlusion. This required a complex interventional reconstruction of the vena cava with secondary stenting of both renal veins. The postoperative venogram showed blood outflow from the left renal vein into the portal vein and from the right renal vein into the inferior vena cava via collaterals. At follow-up presentation, the patient was asymptomatic with normal findings on computed tomography scanning.
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38

Zhao, Xin, Li-xin Li, Hua Fan, Jian-tao Kou, Xian-liang Li, Ren Lang, and Qiang He. "Segmental portal/superior mesenteric vein resection and reconstruction with the iliac vein after pancreatoduodenectomy." Journal of International Medical Research 44, no. 6 (November 10, 2016): 1339–48. http://dx.doi.org/10.1177/0300060516665708.

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Objective The results of segmental venous resection (VR) combined with pancreatoduodenectomy (PD) are controversial but may be promising. Few studies have described reconstruction of the portal/superior mesenteric vein (PV/SMV) with the iliac vein harvested from donation after cardiac death (DCD). Methods From January 2014 to April 2016, PD combined with segmental excision of the PV/SMV (VR group) was performed in 21 patients with adenocarcinoma of the head of the pancreas (ADHP). The authors established a new technique of venous reconstruction using the iliac vein from DCD and analysed patients’ long-term survival. Results The tumour dimensions and tumour staging were greater and the operation time was longer in the VR than PD group; however, no differences in the resection degree, blood loss, complications, reoperation rate, or mortality rate were found. The median survival was similar between the VR and PD groups. The long-term patency of the donor iliac vein was 90%. The degree of resection was a strong predictor of long-term survival. Conclusion Segmental PV/SMV resection combined with PD is applicable to selective patients with venous invasion by ADHP if R0 resection has probably been achieved. An iliac vein obtained by DCD provides an effective graft for venous reconstruction.
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39

Szijártó, Attila, Yasuhiro Fujimoto, Kirino Izumi, and Uemoto Shinji. "Special considerations of living liver donor transplantation." Orvosi Hetilap 154, no. 36 (September 2013): 1417–25. http://dx.doi.org/10.1556/oh.2013.29698.

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Introduction: Due to the limited number of cadaver donors, adult living liver donor transplantation became an alternative for liver transplantation. During living liver donor transplantation, the safety and uncomplicated recovery of the donor are as important as the appropriate volume and weight of the donated graft. The middle hepatic vein causes a significant dilemma, due to the special anatomical position. The reconstruction of the middle hepatic vein branches supplying S5, S8 is suggested when the anatomically right liver lobe is transplanted. Aim: The aim of the present study was to investigate the requirements of the reconstruction of middle hepatic vein and to give an accurate description about the discrepancy between the portal vein in- and outflow. Method: The authors analyzed the liver anatomic characteristics of 130 donors undergoing living liver donor transplantation with the use of MeVis software. The so-called porto-hepatic disparity index (shift) was introduced. Results: The right hepatic vein was dominant in 64.6% of all cases, while the left hepatic vein was never observed to be dominant. The territories of V5 and V8 were responsible for the 33.2±8.9% of the right hepatic lobe area. The correlation between portal venous territory and vein dominancy were as follows: R2= 0.7811 in the left liver lobe; R² = 0.5463 in the area of middle hepatic vein and R² = 0.5843 in the case of the right hepatic vein. The average value of the shift was 28.2%. Conclusions: The differences among the pattern of portal in- and hepatic outflow is an important issue that should be taken into consideration when deciding the necessity for reconstruction of the middle hepatic vein. Orv. Hetil., 2013, 154, 1417–1425.
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40

Sugawara, Yasuhiko, Masatoshi Makuuchi, Sumihito Tamura, Yuichi Matsui, Junichi Kaneko, Kiyoshi Hasegawa, Hiroshi Imamura, Norihiro Kokudo, Noboru Motomura, and Shinichi Takamoto. "Portal vein reconstruction in adult living donor liver transplantation using cryopreserved vein grafts." Liver Transplantation 12, no. 8 (2006): 1233–36. http://dx.doi.org/10.1002/lt.20786.

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41

Tohmatsu, Yuuko, Isaku Yoshioka, Nobutake Tanaka, Kazuto Shibuya, Katsuhisa Hirano, Toru Watanabe, Shigeaki Sawada, Tomoyuki Okumura, Takuya Nagata, and Tsutomu Fujii. "A Case of Splenic Vein Reconstruction Combined with Portal Vein Resection in Pancreatoduodenectomy." Nihon Gekakei Rengo Gakkaishi (Journal of Japanese College of Surgeons) 45, no. 2 (2020): 146–53. http://dx.doi.org/10.4030/jjcs.45.146.

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42

Han, Dong, Xiaoxia Chen, Yuxin Lei, Chunling Ma, Jieli Zhou, Yingcong Xiao, and Yong Yu. "Iodine load reduction in dual-energy spectral CT portal venography with low energy images combined with adaptive statistical iterative reconstruction." British Journal of Radiology 92, no. 1100 (August 2019): 20180414. http://dx.doi.org/10.1259/bjr.20180414.

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Objective: To study the application of using low energy images combined with adaptive statistical iterative reconstruction (ASiR) in dual-energy spectral CT portal venography (CTPV) to reduce iodine load. Methods: 41 patients for CTPV were prospectively and randomly divided into two groups. Group A ( n = 21) used conventional 120 kVp scanning protocol with contrast dose at 0.6 gI/kg while group B ( n = 20) used dual-energy spectral imaging with reduced contrast dose at 0.3 gI/kg. The 120 kVp images in Group A and 50 keV images in Group B were reconstructed with 40% ASiR. The contrast-to-noise ratio of portal vein was calculated. The image quality and the numbers of intrahepatic portal vein branches were evaluated by two experienced radiologists using a 5-point scoring system. Results: Group B reduced iodine load by 52% compared to Group A (17.21 ± 3.30 gI vs 35.80 ± 6.18 gI, p < 0.001). All images in both groups were acceptable for diagnosis. CT values and standard deviations in portal veins of Group B were higher than Group A (all p < 0.05); There were no statistical differences in contrast-to-noise ratio, image quality score and the number of observed portal vein branches between the two groups (all p > 0.05), and the two observers had excellent agreement in image quality assessment (all κ > 0.75). Conclusion: The use of 50 keV images in dual-energy spectral CTPV with ASiR reduces total iodine load by 52% while maintaining good image quality. Advances in knowledge: Spectral CT images combined with ASiR can be used in low contrast dose CTPV portal venography to maintain image quality and reduce contrast dose.
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43

Kleive, D., A. Elnæs Berstad, I. Prydz Gladhaug, C. Verbeke, S. P. Haugvik, P. D. Line, and K. J. Labori. "Superior mesenteric-portal vein reconstruction in pancreatic surgery – comparing reconstruction with cold-stored cadaveric vein allograft versus reconstruction without graft." HPB 18 (April 2016): e85. http://dx.doi.org/10.1016/j.hpb.2016.02.198.

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44

Varsamidakis, Nick, Brian R. Davidson, and Kenneth Hobbs. "Duodeno-Jejunal Varicosities Following Extrahepatic Portal Vein Thrombosis." HPB Surgery 5, no. 2 (January 1, 1992): 147–53. http://dx.doi.org/10.1155/1992/16894.

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A 31 year old man, under investigation for melena, was found at endoscopy to have varicosities at the site of a duodeno-jejunostomy which had been performed for duodenal atresia when he was three days old. Angiography revealed an occluded portal vein with an extensive collateral circulation. At laparotomy some of the collateral vessels were found to pass through the anastomotic site and directly into the left lobe of the liver. The portal pressure was found to be minimally elevated. Resection of the anastomotic segment was performed with reconstruction using a Roux en Y jejunal loop. Bleeding from collateral vessels passing through an anastomosis site in a patient with extrahepatic portal vein thrombosis has not previously been reported.
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45

Yoshioka, Masato, Masahiko Onda, Takashi Tajiri, Koho Akimaru, Sho Mineta, Atsushi Hirakata, and Kaiyo Takubo. "Reconstruction of the portal vein using a peritoneal patch-graft." American Journal of Surgery 181, no. 3 (March 2001): 247–50. http://dx.doi.org/10.1016/s0002-9610(01)00552-9.

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46

Michalski, C., M. Büchler, and T. Hackert. "Standardized approach to portal vein resection and reconstruction in pancreaticoduodenectomy." HPB 18 (April 2016): e120. http://dx.doi.org/10.1016/j.hpb.2016.02.280.

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47

Quatromoni, Jon, Ann Gaffey, Robert Roses, Major Lee, Oksana Jackson, Paul Foley, Ronald Fairman, and Benjamin Jackson. "Shunting for Portal Vein Reconstruction—A Single-Institution Case Series." Journal of Vascular Surgery 72, no. 5 (November 2020): e369. http://dx.doi.org/10.1016/j.jvs.2020.08.092.

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48

Quatromoni, Jon, Ann Gaffey, Robert Swendiman, Robert Roses, Major Lee, Paul Foley, Ronald Fairman, and Benjamin Jackson. "Portal Vein Reconstruction With Interposition Cryopreserved Descending Thoracic Aortic Homograft." Journal of Vascular Surgery 72, no. 5 (November 2020): e369-e370. http://dx.doi.org/10.1016/j.jvs.2020.08.093.

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49

Kokudo, Norihiro, Yasuhiko Sugawara, Junichi Kaneko, Hiroshi Imamura, Keiji Sano, and Masatoshi Makuuchi. "Reconstruction of isolated caudate portal vein in left liver graft." Liver Transplantation 10, no. 9 (2004): 1163–65. http://dx.doi.org/10.1002/lt.20220.

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50

Scantlebury, Velma P. "Successful Reconstruction of Late Portal Vein Stenosis After Hepatic Transplantation." Archives of Surgery 124, no. 4 (April 1, 1989): 503. http://dx.doi.org/10.1001/archsurg.1989.01410040113026.

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