EXPERIMENTAL INVESTIGATION OF THE ROLE OF THE SPLENIC VEIN IN GASTRICVENOUS OBSTRUCTION AFTER PYLORUS-PRESERVING PANCREATICODUODENECTOMY IN THE DOG

Conclusion. This study showed that the splenic vein (SV) plays a major role in maintaining gastric blood flow after ligature of peripyloric vessels in the dog, Therefore, SV preservation or alternative venous d rainage may be recommended to maintain sufficient gastric blood flow i n pylorus-preserving pancreatoduodenectomy (PPPD). Background, In PPPD , we often encounter the problem of gastric venous drainage obstructio n, if the splenic-portal vein confluence needs to be resected. This st udy investigated significance of venous drainage via the left gastric and splenic veins in gastric tissue blood flow. Methods. In seven mong rel dogs, gastric tissue blood flow was measured by both laser Doppler flowmetry (LDF) in the antrum and hydrogen gas clearance (HGC) in the antrum and body, Blood flow was measured after the following treatmen ts: 1. No treatment; 2. Duodenal transection; 3. Ligature of the right gastric and gastroepiploic arteries and veins; 4. Transient obstructi on of the left gastric vein (LGV); 5. Transient obstruction of the SV with the LGV open; and 6. Obstruction of both the LGV and the SV. Resu lts. As judged by LDF, treatments 2, 3, and 4 did not decrease blood f low, but treatments 5 and 6 significantly decreased it compared with b oth treatments 1 and 3, By HGC, changes in the antrum and the body wer e parallel. Duodenal transection did not, but treatments 3 and 4 did d ecrease blood flow compared with no treatment. Obstruction of the left gastric vein did not, but treatments 5 and 6 did significantly decrea se it compared with treatment 3.