SUPERIOR MESENTERIC VEIN ISOLATION TECHNIQUE IN PROXIMAL PANCREAS RESECTION

The aim of investigation was to develop superior mesenteric vein (SMV) isolation technique in proximal pancreas resection, and assess possible ways of its application. Materials and Methods. The characteristic of SMV isolation technique in proximal pancreas resection is primary isolation of the vein in the infra-colic space. In the treatment group (n=13) we used the suggested method of SMV isolation, in the comparison group (n=14) SMV was searched and isolated just near the inferior border of pancreas. We calculated the time required for SMV search and isolation to the inferior border of pancreas, and investigated hemostasis peculiarities. Results. The treatment group patients required less time for SMV search and isolation than those of the comparison group - 16.8 +/- 0.7 versus 21.2 +/- 1.7 min; the difference being significant, p=0.029. Five cases of the comparison group were found to have a diffuse bleeding, and hemostasis appeared to be more time-consuming. Well-defined landmarks - the right border of mesentery and ileocolic vessels - help SMV search in infra-colic space. Conclusion. The technique can be successfully used in dense network of enlarged venous vessels under the inferior border of pancreas, and in overweight patients with massive cellular tissue in SMV search and isolation area. The method can be of help for surgeons with brief experience of proximal pancreas resection.