RESUMEN
Superior mesenteric vein invasion has historically been considered a contraindication for pancreatic cancer resection. Several studies have shown that in selected cases vascular resection can be performed safely. Many techniques have been used to reconstruct the venous flow. We describe one case of mesenteric superior vein resection and reconstrution of mesenteric-portal venous flow using the splenic vein during a pancreatoduodenectomy for pancreatic adenocarcinoma. The patient presented an extensive involvement of the superior mesenteric vein. A segmental resection with an end-to-end anastomosis of this vein and the splenic vein was accomplished after splenectomy. The patient had histologically confirmed negative margins. There was no hospital complications. These results show that the splenic vein can be an option for venous flow reconstruction when a segmental vascular resection is required during at pancreaticoduodenectomy.
RESUMEN
O uso de grampeadores na confecçäo de anastomoses colorretais tem permitido a realizaçäo de anastomoses mais baixas, ao mesmo tempo, porém causou um aumento da incidência de estenoses anastomóticas. Os autores relatam um caso de obstruçäo intestinal baixa por estenose de anastomose mecânica tratado sem laparotomia. A técnica consistiu da ressecçäo da zona estenótica com uso de um grampeador circular aplicado por via anal. Esta técnica demonstrou-se simples e eficaz