Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 28, 2015; 21(24): 7604-7607
Published online Jun 28, 2015. doi: 10.3748/wjg.v21.i24.7604
Resection of the main trunk of the superior mesenteric vein without reconstruction during surgery for giant pancreatic mucinous cystadenoma: A case report
Ying-Tai Chen, Qing-Long Jiang, Zheng Zhu, Shuang Wang, Xin-Min Zhao, Zhong-Min Lan, Xu Che, Jian-Wei Zhang, Liang Cui, Xiao-Long Tang, Cheng-Feng Wang
Ying-Tai Chen, Qing-Long Jiang, Zheng Zhu, Shuang Wang, Xin-Min Zhao, Zhong-Min Lan, Xu Che, Jian-Wei Zhang, Liang Cui, Xiao-Long Tang, Cheng-Feng Wang, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing 100021, China
Author contributions: Chen YT, Zhu Z, Wang S and Zhao XM collected the clinical data; Chen YT, Lan ZM, Che C, Zhang JW, Cui L, Tang XL and Wang CF performed the operation; Chen YT and Jiang QL wrote the paper.
Conflict-of-interest: The authors declare no competing financial interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Cheng-Feng Wang, MD, Cancer Hospital, Chinese Academy of Medical Science, Peking Union Medical College, 17 Panjiayuan Nanli, Beijing 100021, China. chengfengwang1962@163.com
Telephone: +86-10-87787120 Fax: +86-10-87712804
Received: December 18, 2014
Peer-review started: December 19, 2014
First decision: January 22, 2015
Revised: February 12, 2015
Accepted: March 30, 2015
Article in press: March 31, 2015
Published online: June 28, 2015
Processing time: 192 Days and 16.7 Hours
Abstract

Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein (SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for complete resection of pancreatic tumors. However, the optimum surgical method for venous management is controversial. Resection of the SMV without reconstruction during surgery for pancreatic tumors is rarely reported. Here we present the case of a 58-year-old woman with a giant pancreatic mucinous cystadenoma adhering to the SMV, who underwent an en bloc tumor resection, including the main trunk of the SMV and the spleen. No venous reconstruction was performed during surgery. No ischemic changes occurred in the bowel. The presence of several well-developed collateral vessels was shown by 3-dimensional computed tomography examination. The patient had an uneventful postoperative period and was discharged. This case indicated that the main trunk of the SMV can be resected without venous reconstruction if adequate collateralization has formed.

Keywords: Superior mesenteric vein, Pancreatic mucinous cystadenoma, Collateral vessel, Main trunk, Reconstruction

Core tip: Pancreatic tumors, with peri-pancreatic main vascular invasion, especially the superior mesenteric vein (SMV) or the portal vein, are very common. In some cases, vascular resection and reconstruction are required for complete resection of pancreatic tumors. Resection of the SMV without reconstruction during surgery for pancreatic tumors is rarely reported. This report presents the case of a 58-year-old woman with a giant pancreatic mucinous cystadenoma adhering to the SMV, who underwent an en bloc tumor resection, including the main trunk of the SMV and the spleen. No vascular reconstruction was performed after resection of the main trunk of the SMV.