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World Journal of Surgery

, Volume 43, Issue 10, pp 2623–2630 | Cite as

Benign Portal Vein Stenosis After Pancreaticoduodenectomy

  • Katsuhisa Ohgi
  • Teiichi SugiuraEmail author
  • Yusuke Yamamoto
  • Yukiyasu Okamura
  • Takaaki Ito
  • Ryo Ashida
  • Takeshi Aramaki
  • Katsuhiko Uesaka
Original Scientific Report

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.

Notes

Compliance with ethical standards

Conflict of interest

The authors have no funding or conflicts of interest to disclose.

Informed consent

Informed consent was obtained from all individual participants included in the present study.

Human and animal rights

The present study was approved by the institutional review board of the Shizuoka Cancer Center.

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Copyright information

© Société Internationale de Chirurgie 2019

Authors and Affiliations

  • Katsuhisa Ohgi
    • 1
  • Teiichi Sugiura
    • 1
    Email author
  • Yusuke Yamamoto
    • 1
  • Yukiyasu Okamura
    • 1
  • Takaaki Ito
    • 1
  • Ryo Ashida
    • 1
  • Takeshi Aramaki
    • 2
  • Katsuhiko Uesaka
    • 1
  1. 1.Division of Hepato-Biliary-Pancreatic SurgeryShizuoka Cancer CenterShizuokaJapan
  2. 2.Division of Interventional RadiologyShizuoka Cancer CenterShizuokaJapan

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