Temporary Mesenteric-Portal Shunt Using Prosthetic Graft Together with Intermittent Superior Mesenteric Artery Clamping (Pringle-Like) during Complex Venous Resction/Reconstruction in Pancreaticoduodenctomy for Locally Advanced Pancreatic Tumours

Abstract

Introduction: Portal and superior mesenteric vein resection and reconstruction during pancreatic surgery for locally advanced tumors poses a challenging surgical scenario. Potential problems are; major bleeding, prolonged clamping with hepatic ischemia, venous congestion of the gut, and using the more difficult artery first approach. This potentially may increase morbidity and mortality of the procedure. To obviate these potential problems, we propose a pre-emptive temporary SMV-portal venous shunt with intermittent SMA clamping (pringle-like).