A Thought-Provoking Case of Successfully Treated Carcinoma of the Head of the Pancreas with Metachronous Lung Metastasis: Impact of Distal Spleno-Renal Shunt for Regional Invasion on Long-Term Period after Pancreaticoduodenectomy

Figure 2

The distal splenorenal shunt. The confluence of the superior mesenteric vein, portal vein, and splenic vein are resected en bloc. The superior mesenteric vein and portal venous trunk are anastomosed in the end-to-end fashion. The remnant splenic vein is anastomosed to the superior aspect of the left renal vein in the end-to-side fashion. CA: celiac artery; CHA: common hepatic artery; IMV: inferior mesenteric vein; LAdV: left adrenal vein; LGA: left gastric artery; LGV: left gastric vein; LOV: left ovarian vein; LRA: left renal artery; LRV: left renal vein; IVC: inferior vena cava; MCV: middle colic vein; MPD: main pancreatic duct; PV: portal vein; SMA: superior mesenteric artery; SMV: superior mesenteric vein; SpA: splenic artery; SpV: splenic vein.