The role of the left gastric vein in the preservation of the stomach during total duodenopancreatectomy in the modification of Botkin Hospital

Introduction. In total pancreatectomy, the main difficulty of stomach preservation was main vein preservation, especially the left gastric vein. The purpose of this study is to research all the variants of left gastric vein anatomy and prevention of its injuries while performing TP in the modification of the surgical clinic of Botkin Hospital.Materials and methods. A retrospective analysis of the results of total pancreatectomy in patients with pancreatic tumors was carried out in the surgical clinic of Botkin Hospital from September 2007 to November 2022. During the development and implementation of pylorus-preserving total pancreatectomy with spleen preservation in the modification of Botkin Hospital, aspects of the venous anatomy of the stomach, mainly LGV affecting the possibility of performing the modification of TP, were analyzed.Results. A total of 52 pancreatectomies were performed, including 27 pylorus-preserving total pancreatectomies. The most common LGV variant was Ip type, in which LGV passes behind the CHA. This anatomy variant of LGV was observed in 25 patients out of (48%). In 11 (21,2%) patients, LGV was damaged intraoperatively during total pancreatectomy. The incidence of LGV injury differed among variable anatomy types of LGV. As a rule, LGV passing posterior to any vessel was injured more often than the anterior types of LGV.Conclusions. Knowledge of the anatomical variants of LGV, preoperative abdominal CT scan in order to inspect the course of LGV leads to prevention of intraoperative trauma of LGV and the increase in number of performed pylorus-preserving total pancreatectomies.