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Liver and biliary system, pancreas and spleen
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The main portal vein forms at the confluence of the splenic vein and superior mesenteric vein behind the head of the pancreas. It then passes to the liver hilum where it divides into right and left portal vein branches.
A comparison between the mechanical properties of the hepatic round ligament and the portal vein: a clinical implication on surgical reconstruction of the portal and superior mesenteric veins
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Wentao Zhu, Rongqiang Song, Xuefeng Cao, Lei Zhou, Qiang Wei, Haibin Ji, Rongzhan Fu
PV emerges from the convergence of the superior mesenteric vein (SMV) and the splenic vein behind the neck of the pancreas, which carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. Abdominal tumors, such as vater ampulla carcinoma (VAC) and pancreatic cancer (PC), can invade the PV and SMV when developing into later metastatic stages (Rosch et al. 1992). Especially for the PC, due to its specific biological behavior, it is often not diagnosed until the mid and late stages, where the metastatic tumor has already invaded the PV and the SMV owing to their close anatomical association (Harrison and Brennan 1997). Tumor invasion into PV and SMV is previously considered as a restraint for surgical procedures, which greatly increases the lethality caused by VAC and PC. Recently, with the continuous improvement of abdominal surgical techniques, successful cases of combined PV and SMV resection have gradually increased. In addition, surgical approaches in pancreaticoduodenectomy coupled with PV and SMV resection have also gradually matured (Marsoner et al. 2016). These advancements have dramatically improved the long-term therapeutic effect of tumors associated with VAC and PC. After the surgery, end-to-end anastomosis is the most suitable way to reattach the broken vessels. However, if a large portion of the vessel is removed, direct end-to-end anastomosis will create too much tension at the connecting sites. Therefore, choosing a suitable interstitial PV and SMV reconstruction material with good tissue compatibility for the vessel is urgently needed.
Surgical planning for living donor liver transplant using 4D flow MRI, computational fluid dynamics and in vitro experiments
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2018
David R. Rutkowski, Scott B. Reeder, Luis A. Fernandez, Alejandro Roldán-Alzate
The in vivo donor imaging and flow quantification results are shown in Table 2. Note that in cases 1 and 2, the right portal vein was resected during surgery, thus post-surgery flow values for this vessel are non-existent and all flow is directed through the left portal vein, where flow is shown to increase significantly post-surgery. Likewise, case 3 results display no flow through the left portal vein branch, as it was resected during left lateral lobectomy. Despite this change, the ratio of superior mesenteric vein to splenic vein flow remained the same after surgery in donor 1. However, the SMV to SV flow ratios for donors 2 and 3 did change from pre to post surgery scans.