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

  • Katsunori Sakamoto,
  • Yukiharu Iwamoto,
  • Kohei Ogawa,
  • Oğuzhan Şal,
  • Kei Tamura,
  • Takahiro Hikida,
  • Chihiro Ito,
  • Miku Iwata,
  • Akimasa Sakamoto,
  • Mikiya Shine,
  • Yusuke Nishi,
  • Mio Uraoka,
  • Tomoyuki Nagaoka,
  • Masahiko Honjo,
  • Naotake Funamizu,
  • Yasutsugu Takada

摘要

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.