This study was conducted to assess the efficacy of portal vein reconst
ruction with an expanded polytetrafluoroethylene (e-PTFE) graft. Five
patients underwent interposition of the portal vein with e-PTFE graft
following en bloc resection of the entire pancreas and the portal vein
for advanced pancreatic cancer. The length of the excised vein ranged
from 5 to 7 cm and that of the implanted graft (8 or 10 mm in diamete
r), 3 to 7.5 cm. In 4 of the 5 cases, the graft was patent at five to
eighteen months following implantation. One patient died of respirator
y failure two months after operation, and partial occlusion of the gra
ft was noted at autopsy. Four patients died of recurrence of the origi
nal disease five to eighteen months after operation. The implanted gra
ft taken at autopsy eighteen months after operation was covered unifor
mly with thin neointima on the internal surface. Microscopic examinati
on showed endothelial cells covering the surface of the neointima, and
capillary vessels had developed in the neointimal layer. Experimental
ly, five grafts, 0.8 cm in diameter and 2.5 cm in length with external
ring support, were interposed in the portal vein in pigs. All grafts
were patent during a four-month follow-up period. The authors conclude
that the e-PTFE graft is a suitable prosthesis for replacement of the
portal vein following its resection.