OBJECTIVE To investigate patency and clinical outcomes of alloplastic and other venous interposition graft materials in pancreatic surgery. BACKGROUND Vascular pancreatic surgery is increasingly performed for locally advanced pancreatic neoplasms. Different than other centers, we prefer to use alloplastic vascular graft materials for superior mesenteric vein and portal vein interposition in pancreatic surgery. Advantages are off-the-shelf availability at any customizable length, different diameters, and ring-enforcement but proposed concerns are their thrombogenicity and fatal complications. METHODS Patients who underwent elective pancreatic resections with mesoportal venous interposition grafts (ISGPS type 4) between 2003-2022 were identified from the institutional pancreatectomy registry. Alloplastic vascular grafts imply synthetic materials, either based on polytetrafluorethylene (PTFE) or polyethylene terephthalate (PET). Surgical details, clinicopathological, and follow-up data were analyzed. The patients were followed for graft patency by cross-sectional imaging. RESULTS In this study, 201 patients with venous interposition grafts were included (23% simultaneous arterial resections). Total pancreatectomy (41%) and pancreatoduodenectomy (35%) were the most frequent procedures. Vascular graft materials were alloplastic in 180 patients (83% PTFE and 17% PET) with a median diameter of 10 mm and a median length of 33 mm (measurement by CT scan). Patency rates among all graft materials at 7-, 30-, and 90-days were 99%, 93%, and 87%. Alloplastic grafts demonstrated superior patency over other materials (hazard ratio 2.7, P=0.009), and PTFE reached a 1-year patency of 78%. The all-cause 90-day mortality rate was 10%. No graft infection occurred. CONCLUSION Alloplastic venous vascular grafts are safe and readily available tools in pancreatic surgery, especially for long-segmental mesoportal venous reconstructions.

中文翻译：

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用于胰腺手术静脉插入的同种异体血管移植物：容易获得且可靠。


目的 探讨胰腺手术中同种异体和其他静脉插入移植物材料的通畅性和临床结局。背景 血管胰腺手术越来越多地用于局部晚期胰腺肿瘤。与其他中心不同，我们更喜欢在胰腺手术中使用同种异体血管移植材料进行肠系膜上静脉和门静脉插入。优点是任何可定制长度、不同直径和环执行的现成可用性，但提出的问题是它们的血栓形成性和致命并发症。方法 从 机构胰腺切除术登记处确定 2003-2022 年间接受择期胰腺切除术联合门静脉插入移植物 （ISGPS 4 型） 的患者。同种异体增生性血管移植物是指基于聚四氟乙烯 （PTFE） 或聚对苯二甲酸乙二醇酯 （PET） 的合成材料。分析手术细节、临床病理和随访资料。通过横断面成像跟踪患者的移植物通畅情况。结果 在本研究中，纳入了 201 例静脉插入移植物患者 （23% 同时动脉切除术）。全胰腺切除术 （41%） 和胰十二指肠切除术 （35%） 是最常见的手术。180 例患者 （83% PTFE 和 17% PET） 血管移植材料为异体，中位直径为 10 mm，中位长度为 33 mm （通过 CT 扫描测量）。所有移植物材料在 7 天、 30 天和 90 天的通畅率为 99% 、 93% 和 87%。同种异体增生移植物表现出优于其他材料的通畅性 （风险比 2.7，P=0.009），PTFE 的 1 年通畅率达到 78%。全因 90 天死亡率为 10%。未发生移植物感染。 结论 同种异体静脉血管移植物是胰腺手术中安全且容易获得的工具，尤其是对于长节段门中静脉重建。