Eleven-year patency of ligamentum teres hepatis graft for portal vein and superior mesenteric vein reconstruction following pancreaticoduodenectomy: A case report

RATIONALE: Pancreaticoduodenectomy combined with portal vein and/or superior mesenteric vein resection and reconstruction is a safe and effective surgical procedure. However, identifying suitable revascularization materials remains challenging. PATIENT CONCERNS: We report a rare case of 11-year patency following reconstruction of the ligamentum teres hepatis with vein reconstruction. The patient's diagnosis, treatment, and postoperative follow-up are summarised and analysed. DIAGNOSES: The patient was diagnosed with a neuroendocrine tumor of the pancreatic head. INTERVENTIONS: We conducted a pancreaticoduodenectomy with resection of a 3-cm segment at the portal superior mesenteric vein confluence. OUTCOMES: We reconstructed the vein using a recanalized autologous ligamentum teres hepatis (LTH) graft. No long-term anticoagulation therapy was administered. The graft remained patent throughout an 11-year postoperative follow-up, during which the patient remained tumor-free and in good general condition. LESSONS: This case provides rare long-term data supporting the feasibility of using the LTH as an autologous graft for venous reconstruction. Given its accessibility, structural similarity to native veins, and potential for long-term patency, the LTH may be considered a viable substitute in complex portal venous reconstruction during pancreatic surgery.