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Anticancer Res ; 39(12): 6603-6620, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31810926

ABSTRACT

BACKGROUND: In clinical medicine, little is known about the use of allografts for portal vein (PV) reconstruction after pancreaticoduodenectomy (PD). Portal and caval systems are physiologically different, therefore the properties of allografts from caval and portal systems were studied here in a pig model. MATERIALS AND METHODS: PD with PV reconstruction with allogeneic venous graft from PV or inferior vena cava (IVC) was performed in 26 pigs. Biochemical analysis and ultrasonography measurements were performed during a 4-week monitoring period. Computer simulations were used to evaluate haemodynamics in reconstructed PV and explanted allografts were histologically examined. RESULTS: The native PV and IVC grafts varied in histological structure but were able to adapt morphologically after transplantation. Computer simulation suggested PV grafts to be more susceptible to thrombosis development. Thrombosis of reconstructed PV occurred in four out of five cases in PV group. CONCLUSION: This study supports the use of allografts from caval system for PV reconstruction in clinical medicine when needed.


Subject(s)
Computer Simulation , Pancreaticoduodenectomy , Portal Vein/surgery , Vena Cava, Inferior/transplantation , Allografts , Anastomosis, Surgical/methods , Animals , Cadaver , Female , Hemodynamics , Male , Organ Size , Organ Sparing Treatments , Portal Vein/anatomy & histology , Portal Vein/diagnostic imaging , Portal Vein/physiology , Postoperative Complications/etiology , Pylorus , Plastic Surgery Procedures/methods , Regional Blood Flow , Swine , Tissue and Organ Harvesting , Ultrasonography , Vena Cava, Inferior/anatomy & histology , Vena Cava, Inferior/diagnostic imaging , Vena Cava, Inferior/physiology , Venous Thrombosis/etiology
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