PMC4246678_01
(A) Cross-sectional enhanced-abdominal computed tomography prior to surgery reavealing a low-attenuated mass in the pancreatic neck that was 3 cm in diameter and adhered to the portal vein. (B) Specimen from en bloc resection of the pancreas, spleen and superior mesenteric-portal vein (SMPV). The white arrow indicates the ~4-cm resected segment of the SMPV. (C) The surgical field post-surgery revealing the 4-cm vascular graft (GORE-TEX; diameter, 0.8 cm) used to carry out the vascular reconstruction. (D, E and F) Hematoxylin and eosin staining revealing a histological view of the resected pancreas (original magnification, x100). (D) A moderately-differentiated invasive ductal adenocarcinoma (E) invaded the muscle layer of the portal vein wall and (F) peripancreatic nerve bundle.
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The tumor was adhered to the portal vein, but there was no evidence of distant metastasis (Fig. 1A). Therefore, a 4-cm segment of the SMPV (Fig. 1B) was resected for a margin-negative resection. The vascular reconstruction was performed using a 4-cm long vascular graft (GORE-TEX; diameter, 0.8 cm; Gore Medical, Newark, DE, USA; Fig. 1C). The 12 lymph nodes examined were negative for any histological evidence of regional lymph node metastasis (Fig. 1D-F).