Detailed Abstract
[BP Oral Presentation 2 - Biliary & Pancreas (Biliary Disease/Surgery)]
[BP OP 2-S5] The Clinical Features of Portal Vein after Pancreatoduodenectomy; Long-term Serial Follow up
Naru KIM 1, Dae Wook HWANG 2, Hongeun LEE 2, Yejong PARK 2, Woohyung LEE 2, Jae Hoon LEE 2, Ki Byung SONG 2, Song Cheol KIM 2, Soyeon KIM 3
1 Hepatobiliary-pancreatic Surgery , Ewha Womans University Mokdong Hospital, REPUBLIC OF KOREA, 2 Hepatobiliary And Pancreatic Surgery , Asan Medical Center, REPUBLIC OF KOREA, 3 Radiology And Research Institute of Radiology, Asan Medical Center, REPUBLIC OF KOREA
Background : Post-pancreaticoduodenectomy(PD) portal vein(PV) stenosis and obstruction can cause portal hypertension, leading to decreased liver function, uncontrolled ascites, gastrointestinal bleeding, sometimes leading to patient death. The aim of this study is to describe the clinical presentation of PV stenosis after PD serially.
Methods : In a retrospective study of 1040 patients who underwent PD for periampullary disease from 2014 to 2016, preoperative computed tomography (CT), CT on day 5 after surgery, and regular follow-up CT were serially reviewed to document postoperative changes in the PV and superior mesenteric vein (SMV). Follow-up was performed until December 2019.
Results : In the cohort, 554 (53.3%) patients developed immediate postoperative PV stenosis, of which 92.8% patients recovered. However, 17.3% patients experienced restenosis during follow-up after initial recovery. The locations of immediate stenosis were main PV (44.6%), SMV (33.2%), and PV-SMV junction (22.2%), respectively. Of the 486 patients who did not experience immediate stenosis, 20.2% patients had late stenosis, and the total number of patients with long-term stenosis was 226 (21.7%) of all surgical patients. All of the long-term stenosis, 28 (12.4%) underwent PV intervention, 27 underwent stenting, and 1 underwent balloon dilation only. The success rate of intervention was 89.3% (25 patients), and the time of interval of stenosis detection to intervention was 208 day. The PV stent of 3year patency after intervention was 80.0% (20 out of 25 patients).
Conclusions : After PD surgery, PV diameter changes dynamically over time, and intervention may be an option for PV stenosis.
Methods : In a retrospective study of 1040 patients who underwent PD for periampullary disease from 2014 to 2016, preoperative computed tomography (CT), CT on day 5 after surgery, and regular follow-up CT were serially reviewed to document postoperative changes in the PV and superior mesenteric vein (SMV). Follow-up was performed until December 2019.
Results : In the cohort, 554 (53.3%) patients developed immediate postoperative PV stenosis, of which 92.8% patients recovered. However, 17.3% patients experienced restenosis during follow-up after initial recovery. The locations of immediate stenosis were main PV (44.6%), SMV (33.2%), and PV-SMV junction (22.2%), respectively. Of the 486 patients who did not experience immediate stenosis, 20.2% patients had late stenosis, and the total number of patients with long-term stenosis was 226 (21.7%) of all surgical patients. All of the long-term stenosis, 28 (12.4%) underwent PV intervention, 27 underwent stenting, and 1 underwent balloon dilation only. The success rate of intervention was 89.3% (25 patients), and the time of interval of stenosis detection to intervention was 208 day. The PV stent of 3year patency after intervention was 80.0% (20 out of 25 patients).
Conclusions : After PD surgery, PV diameter changes dynamically over time, and intervention may be an option for PV stenosis.
SESSION
BP Oral Presentation 2
Room C 3/22/2024 4:30 PM - 5:30 PM