The type of portal vein reconstruction does not affect the outcomes of pancreatic surgery or the patency of the portal vein.

Authors

Juha Virtanen, Ellinoora Aro, Ivika Heinola, Arto Kokkola, Caj Haglund, Ilkka Kantonen, Hanna Seppänen, Pirkka Vikatmaa

Published in

Annals of vascular surgery. Oct 14, 2026. Epub Oct 14, 2026.

Abstract

To evaluate the safety of the four types of portal vein reconstruction (PVR) as defined by the International Study Group of Pancreatic Surgery (ISGPS) and to analyse long-term survival outcomes in patients with pancreatic ductal adenocarcinoma (PDAC).
A prospectively collected pancreatic surgery registry that was supplemented retrospectively was used. Patients who underwent open pancreatic resection with PVR between 2005 and 2024 were included. Clinicopathological characteristics, outcomes, and computed tomography images were analysed and tested in multivariate and survival analyses. For survival analyses, patients with PDAC who underwent pancreatectomy without PVR served as controls.
Pancreatectomies with PVR (n=386) comprised 63 tangential resections with venorrhaphy (ISGPS type I), 25 patch reconstructions (type II), 147 end-to-end anastomoses (type III), and 151 resections with graft interposition (type IV). Most type IV reconstructions (98.7%) used spiral grafts, predominantly made from the great saphenous vein (GSV). PVR thrombosis rate was 3.1% at 30 days and 5.7% at 90 days following surgery. There were no significant differences between PVR types I-IV in the incidence of PVR thromboses, complications, or mortality. Median survival for PDAC patients with PVR was 22.8 months, with no survival differences between types I-IV, compared with 31.7 months in patients without PVR, p=.003.
In this setting, where PVR was performed using GSV spiral grafts for interposition, the type of PVR did not associate with pancreatic surgery outcomes or portal vein patency. The rate of PVR thrombosis was low, and other complication rates and long-term survival outcomes were comparable with international standards.

PMID:
42874864
Bibliographic data and abstract were imported from PubMed on 15 Oct 2026.

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