Gastric venous congestion after total pancreatectomy: how serious is the problem?
https://doi.org/10.21294/1814-4861-2025-24-5-107-112
Abstract
Introduction. Gastric venous congestion (GVC) after total pancreatectomy (TP) remains a challenging condition which may result in stomach necrosis or bleeding. Here, we present a short series of TPs with two cases of GVC successfully managed by restoring the coronary vein outflow.
Material and Methods. A total of 11 patients were eligible for our study due to stomach-preserving TP. The incidence of GVC and risk factors were estimated. Results. GVC was observed in 2 of 11 patients (18.2 %). The complication was successfully managed by the reconstruction of the gastric coronary vein. The regression model revealed that coronary vein ligation was the only significant predictor of GVC (OR=10.38 [3.97–27.94]). The risk of GVC with the preserved coronary vein was low (OR=0.12 [0.02–0.55]). No gastrectomy was required in both cases.
Conclusion. GVC is a frequent complication of total pancreatectomies which may result in life-threatening conditions, such as stomach necrosis or bleeding. Gastric coronary vein reconstruction is a safe procedure which allows the surgeon to escape unnecessary gastrectomies.
About the Authors
D. A. Chichevatov
Penza State University
Russian Federation
Russian Federation
Dmitry A. Chichevatov - MD, DSc, Professor, Department of Surgery
Researcher ID (WOS): Q-3647-2017
40, Krasnaya St., Penza, 440026
V. V. Kalentjev
Penza Regional Oncology Hospital
Russian Federation
Russian Federation
Vyacheslav V. Kalentjev - MD, MSc, Surgeon, Department of Surgery.
37a, Prospect Stroiteley, Penza, 440066
A. E. Glukhov
Penza State University
Russian Federation
Russian Federation
Artem E. Glukhov - MD, MSc, Assistant, Department of Surgery.
40, Krasnaya St., Penza, 440026
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Supplementary files
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1. Fig. 1. Posterior predictive check: y – row values; yrep – predicted values Note: created by the authors | |
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2. Fig. 2. A. TP with PMR: 1 – the stump of the common bile duct; 2 – SMA; 3 – the anastomosis of the gastric coronary vein to the left renal vein; 4 – the portomesenteric anastomosis. B. The CT scan of the same patient at postoperative day 7. The arrow points to the wellfunctioning venous anastomosis. Note: created by the authors | |
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3. Fig. 3. TP with PMR: 1 – the gastric coronary vein; 2 – the portomesenteric anastomosis; 3 – the right gonadal vein; 4 – HA. Note: created by the authors | |
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For citations:
Chichevatov D.A., Kalentjev V.V., Glukhov A.E. Gastric venous congestion after total pancreatectomy: how serious is the problem? Siberian journal of oncology. 2025;24(5):107-112. https://doi.org/10.21294/1814-4861-2025-24-5-107-112
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