Impact of reconstructed portal vein morphology on postoperative nutritional status in pancreatoduodenectomy: a computational fluid dynamics study

• Published in: Surgery today (Tokyo, Japan) Japan), 2024-07
• Main Authors: Sakamoto, Katsunori, Iwamoto, Yukiharu, Ogawa, Kohei, Şal, Oğuzhan, Tamura, Kei, Hikida, Takahiro, Ito, Chihiro, Iwata, Miku, Sakamoto, Akimasa, Shine, Mikiya, Nishi, Yusuke, Uraoka, Mio, Nagaoka, Tomoyuki, Honjo, Masahiko, Funamizu, Naotake, Takada, Yasutsugu
• Format: Article
• Language: English
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-024-02903-0

This study evaluated the impact of reconstructed portal vein/superior mesenteric vein (PV/SMV) morphology on the long-term nutritional status following pancreatoduodenectomy (PD) using computational fluid dynamics (CFD). Twenty-four patients who underwent PD with PV/SMV resection and reconstruction without tumor recurrence for over 9 months after the operation were enrolled in the study. Three-dimensional models were constructed from computed tomography images obtained 3-6 months postoperatively. The pressure (p) at the inlet and turbulence dissipation rate (ε) at the outlet were investigated in the models. Patients with values of either p or ε above the upper interquartile range were classified as the poor flow group. The prognostic nutritional index improvement rate was significantly lower at 9 postoperative months in the poor flow group than in the good flow group (P = 0.016). This finding indicates the utility of a CFD analysis for evaluating the reconstructed PV/SMV morphology.