scholarly journals Splenic vein graft for the reconstruction of the mesenteric-portal trunk after gastroduodenopancreatectomy

2014 ◽  
Vol 41 (5) ◽  
pp. 381-383 ◽  
Author(s):  
Enio Campos Amico ◽  
José Roberto Alves ◽  
Samir Assi João
Keyword(s):  
Vein Graft ◽  
Splenic Vein ◽  
Technical Note ◽  
Venous Grafts ◽  
Portal Veins ◽  
Adenocarcinoma Of The Pancreas ◽  
Positive Results ◽  
Portal Trunk

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.

scholarly journals A macroscopical investigation of the portal veins of the Van cat 

2012 ◽  
Vol 50 (No. 2) ◽  
pp. 77-84 ◽  
Author(s):  
Z. Ozudogru ◽  
Z. Soyguder ◽  
G. Aksoy ◽  
H. Karadag
Keyword(s):  
Portal Vein ◽  
Splenic Vein ◽  
Common Trunk ◽  
Mesenteric Vein ◽  
Left Branch ◽  
Abdominal Organs ◽  
Portal Veins ◽  
The Right

In this study veins that constituted the portal vein were investigated in eight adult Van cats. The portal vein of the Van cat was composed of five peripheral branches which supplied the abdominal organs and two intrahepatic branches at the hepatic porta. The peripheral branches were cranial mesenteric, splenic, gastroduodenal, right gastric and cystic veins. The cranial mesenteric vein was the largest vessel that joined to the portal vein, and was constituted by the caudal pancreaticoduodenal, ileal, ileocolic and jejunal veins. The splenic vein was formed by the left gastric, left gastroepiploic, pancreatic and short gastric veins. The gastroduodenal vein was formed by the cranial pancreaticoduodenal and right gastroepiploic veins. The right gastric vein separately joined to the portal vein. The caudal mesenteric vein joined to the portal vein either alone or by a common trunk receiving either the caudal pancreaticoduodenal vein or ileocolic vein. The caudal mesenteric vein also opened rarely into the splenic vein. Intrahepatic branches were the right branch which gave off the ramus caudatus and ramus dexter lateralis, and the left branch which gave off the ramus dexter medialis, ramus quadratus, ramus sinister lateralis and ramus sinister medialis.

scholarly journals The Congenital Absence of the Portal Vein

2020 ◽  
pp. 1-2
Author(s):  
M Lagrine ◽  
◽  
A Bourrahouat ◽  
I Ait Sab ◽  
M Sbihi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Portal Vein ◽  
Superior Mesenteric Vein ◽  
Liver Tumors ◽  
Splenic Vein ◽  
Abdominal Ultrasound ◽  
Congenital Absence ◽  
Grade Ii ◽  
Upper Gastrointestinal ◽  
Portal Trunk

Congenital absence of the portal vein (CAPV) is a rare defect often accompanied by other abnormalities such as heart defect, skeletal anomalies and / or liver tumors [1]. We describe here a case of CAPV revealed by an upper gastrointestinal tract hemorrhage in a child aged 02 years and 8 months. The esogatro-duodenal fibroscopy revealed the presence of Esophageal varices grade II, abdominal ultrasound revealed a large liver with no visualization of the spleen. Subsequent abdominal computed tomography revealed the presence of a spleno-mesaraic trunk measuring 7 mm in anteroposterior diameter receiving the inferior and superior mesenteric vein and a small splenic vein draining by dilated peri-gastric and peri-esophageal leads. Associated with splenic hypoplasia and portal trunk atresia. The rest of the malformative assessment was negative

Splenic vein Aneurysm with Calcification of Splenic and Portal Veins

2005 ◽  
Vol 33 (5) ◽  
pp. 251-253 ◽  
Author(s):  
Ercan Kocakoc ◽  
Adem Kiris ◽  
Zulkif Bozgeyik ◽  
Hadi Uysal ◽  
Hakan Artas
Keyword(s):  
Splenic Vein ◽  
Portal Veins

The Valveless Saphenous Vein Graft Technique for EC-IC High-Flow Bypass: Technical Note

2016 ◽  
Vol 87 ◽  
pp. 35-38 ◽  
Author(s):  
Hidetoshi Matsukawa ◽  
Rokuya Tanikawa ◽  
Hiroyasu Kamiyama ◽  
Toshiyuki Tsuboi ◽  
Kosumo Noda ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Technical Note ◽  
High Flow

scholarly journals Splenic Vein Embolization Using Coil Anchors and Prophylactic Occlusion of a Hepatofugal Collateral for Hepatic Encephalopathy due to Splenorenal Shunt: Technical Note and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Masayoshi Inoue ◽  
Toshihiro Tanaka ◽  
Hiroyuki Nakagawa ◽  
Tetsuya Yoshioka ◽  
Kimihiko Kichikawa
Keyword(s):  
Hepatic Encephalopathy ◽  
Venous Pressure ◽  
Splenic Vein ◽  
Treatment Strategies ◽  
Ammonia Level ◽  
Technical Note ◽  
Splenorenal Shunt ◽  
Interventional Treatment ◽  
Serum Ammonia Level ◽  
Serum Ammonia

Purpose. Interventional treatment strategies for patients with encephalopathy due to splenorenal shunt remain controversial. Portosplenic blood flow separation by occluding the splenic vein could avoid the complication of severe portal hypertension, but it would require repeated reintervention due to recurrence of symptoms. This paper describes occlusion of the splenic vein using coil anchors and prophylactic embolization of a collateral hepatofugal vessel with no recurrence of hyperammonemia.Materials and Methods. A 51-year-old woman with severe cirrhosis had hepatic encephalopathy due to a large splenorenal shunt. The serum ammonia level was 132 μg/dL. Via a transileocolic approach, the splenic vein was completely embolized with 0.035-inch metallic coils using coil anchors while preserving the splenorenal shunt. In addition, one of the collateral vessels of the portal vein, the retrogastric vein, was also embolized prophylactically.Results. After this procedure, the serum ammonia level decreased immediately to 24 μg/dL. The portal venous pressure increased by only 1.5 mmHg. Hepatic encephalopathy had not been observed for 25 months after the procedure, and neither retention of ascites nor worsening of esophageal varices and liver function was observed.Conclusion. This procedure appears to be safe and effective for hepatic encephalopathy caused by a splenorenal shunt.

Antithrombotic Therapy in Non-Neoplastic Chronic Portal Venous Thrombosis in Cirrhosis: Recanalization and Liver Function Evaluation,

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3358-3358 ◽  
Author(s):  
Leyre Bento ◽  
Ana Rodriguez Huerta ◽  
Cristina Pascual ◽  
Gloria Pérez Rus ◽  
Vega Catalina ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Function ◽  
Antithrombotic Therapy ◽  
Conflicts Of Interest ◽  
Anticoagulation Therapy ◽  
Splenic Vein ◽  
Liver Function Tests ◽  
Vein Thrombosis ◽  
Function Tests ◽  
Portal Trunk

Abstract Abstract 3358 INTRODUCTION: Non-neoplastic chronic portal vein thrombosis (PVT) is a frecuent diagnosis in the course of liver cirrhosis, with reported prevalences of 0.6% to 15,8%. PVT can motivate life-threatening complications due to worsening portal hypertension, so anticoagulation therapy is challenging in these patients. OBJECTIVE: To analyze the response to antithrombotic therapy and changes in liver function tests in 28 patients with chronic PVT associated with cirrhosis. PATIENTS AND METHODS: 28 consecutive patients with liver cirrhosis and chronic PVT were treated with antithrombotic therapy from 2004 to 2009. Hepatocellular carcinoma and known thrombophilic risks were ruled out. Therapy consisted in 15 days of therapeutic doses of low molecular weight heparin (LMWH) (enoxaparin) adjusted according to baseline coagulability (Table 1), followed by either prophylactic doses (40mg/day) of LMWH or acenocoumarol (target INR 2–3), during 6 months. Response was evaluated after 6 months. If recanalization was complete, therapy was suspended. If recanalization was partial or no recanalization was observed, therapy was continued until response. RESULTS: From the 28 patients studied, 19 (68%) were males with a median age of 53 years (range 35–77). Cirrhosis was due to alcoholism (25%), virus (54%), mixed in 1 patient and other causes in 3 patients. PVT involved the portal trunk and/or branches in 19/28 (68%) patients, mesenteric vein in 2 patients and portal trunk and/or branches, mesenteric and/or splenic vein thrombosis coexisted in 7 patients. 19/28 (68%) of the patients had moderate or moderate-severe hypocoagulability range. Complete and partial thrombosis was seen in 18 and 10 patients at diagnosis, respectively. From the 28 patients, 18 (64%) responded to antithrombotic therapy after 6 months, with a complete recanalization in 13 patients 13/18 (72%) and partial in 5/18 patients (28%). None of the 28 patients presented hemorrhagic complications and none showed platelets counts below baseline values. 17 from the 18 patients who responded, showed altered liver function tests before therapy. After 6 months, 8/17 (47%) improved liver function (only one patient had received antiviral therapy). After a median follow up of 42 months (range 7–67), 15/18 (83%) patients continued showing complete or partial response while 3 patients progressed. Of note, 3 patients of this group could proceed to further liver transplantation. CONCLUSIONS: Antithrombotic therapy in chronic PVT in cirrhotic patients resulted in a high response rate (64%) in our study, with a complete recanalization in 72% of the cases. Adjusted dose scheme according to level of hypocoagulability seems to be effective and safe, since 63% of the subgroups of moderate and moderate-severe hypocoagulability responded with no haemorrhagic complications. Disclosures: No relevant conflicts of interest to declare.

Carbon dioxide wedged arterial splenoportography: A new technique—a case report and an experimental study

2009 ◽  
Vol 50 (3) ◽  
pp. 265-269 ◽  
Author(s):  
S. C. H. Yu ◽  
K. J. Cho
Keyword(s):  
Computed Tomography ◽  
Carbon Dioxide ◽  
Experimental Study ◽  
Splenic Vein ◽  
Gastric Varices ◽  
New Technique ◽  
Vein Occlusion ◽  
Arterial Portography ◽  
Splenic Vein Occlusion ◽  
Portal Veins

Background: Patients with splenic vein occlusion may present a diagnostic problem when the location, morphology, and cause of the obstructive lesion and the associated collateral veins cannot be clearly defined by standard diagnostic imaging modalities such as computed tomography, magnetic resonance venography, or indirect splenoportography (arterial portography). Purpose: To evaluate the safety and effectiveness of carbon dioxide (CO2) wedged arterial splenoportography for definitive investigation of splenic vein occlusion. Material and Methods: Following unsuccessful diagnosis with computed tomography and standard contrast arterial portography in a patient with recurrent gastric variceal bleeding, CO2 was injected into a wedged splenic arterial catheter and successfully outlined splenic vein occlusion and gastric varices. Our experience with this patient prompted us to perform an experimental study in swine to evaluate the safety and effectiveness of CO2 wedged arterial splenoportography for visualization of the splenic and portal veins. A microcatheter was advanced coaxially and wedged into the splenic arteries of three pigs. After checking the wedged positioning with contrast medium injection, CO2 was injected manually and the splenic region imaged. The spleens were then removed for gross and microscopic examinations. Results: In the patient, CO2 wedged arterial splenoportography demonstrated gastric varices associated with splenic vein occlusion. In all animals, CO2 wedged arterial splenoportography visualized the splenic and portal veins. No CO2 extravasations occurred in the spleen. Gross and microscopic examinations revealed no evidence of splenic rupture or intrasplenic hematoma. Conclusion: CO2 wedged arterial splenoportography may be a useful method for visualizing gastric varices associated with splenic vein occlusion. This new technique has the potential to replace the standard splenic arterial portography for visualization of splenic and portal veins, thus eliminating the need for injection of a large volume of iodinated contrast material. Further clinical studies are justified to evaluate this technique.

New AAC Access Strategy for Gesture Tracking: A Technical Note

2012 ◽  
Vol 21 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Susan Fager ◽  
Tom Jakobs ◽  
David Beukelman ◽  
Tricia Ternus ◽  
Haylee Schley
Keyword(s):  
Augmentative And Alternative Communication ◽  
Technical Note ◽  
Head Tracking ◽  
Alternative Communication ◽  
Access Methods ◽  
Cord Injury ◽  
Physical Limitations ◽  
Gesture Tracking ◽  
Communication Needs ◽  
Tracking Device

Abstract This article summarizes the design and evaluation of a new augmentative and alternative communication (AAC) interface strategy for people with complex communication needs and severe physical limitations. This strategy combines typing, gesture recognition, and word prediction to input text into AAC software using touchscreen or head movement tracking access methods. Eight individuals with movement limitations due to spinal cord injury, amyotrophic lateral sclerosis, polio, and Guillain Barre syndrome participated in the evaluation of the prototype technology using a head-tracking device. Fourteen typical individuals participated in the evaluation of the prototype using a touchscreen.

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