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Hertel et al: Successful venotomy for portal tumor thrombus removal due to pancreatic carcinoma in a dog
Veterinary Surgery 5, 2025

🔍 Key Findings

  • Portal venotomy enabled successful en bloc resection of a pancreatic insulinoma and associated thrombus in the portal vein, a novel approach in veterinary literature.
  • Temporary portal vein occlusion (15 min) was well tolerated, causing only transient small intestinal congestion without lasting hemodynamic compromise.
  • No intraoperative hemorrhage occurred following vascular isolation and venotomy repair with 5–0 polypropylene in a simple continuous pattern.
  • Postoperative complications were minimal, with only moderate pancreatitis managed medically and no portal hypertension observed on follow-up imaging.
  • Histopathology confirmed insulinoma, with no initial metastasis; CT at 6 months revealed hepatic and peritoneal metastases but no local recurrence at the venotomy site.
  • Portal vein luminal stenosis occurred post-repair but was clinically insignificant.
  • Advanced CT imaging and 3D printed modeling significantly enhanced surgical planning and anatomical assessment.
  • Surgical excision achieved good short-term outcomes, and the dog was alive and euglycemic one year later despite metastatic disease.

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← Articles

Hertel et al: Successful venotomy for portal tumor thrombus removal due to pancreatic carcinoma in a dog
Veterinary Surgery 5, 2025

🔍 Key Findings

  • Portal venotomy enabled successful en bloc resection of a pancreatic insulinoma and associated thrombus in the portal vein, a novel approach in veterinary literature.
  • Temporary portal vein occlusion (15 min) was well tolerated, causing only transient small intestinal congestion without lasting hemodynamic compromise.
  • No intraoperative hemorrhage occurred following vascular isolation and venotomy repair with 5–0 polypropylene in a simple continuous pattern.
  • Postoperative complications were minimal, with only moderate pancreatitis managed medically and no portal hypertension observed on follow-up imaging.
  • Histopathology confirmed insulinoma, with no initial metastasis; CT at 6 months revealed hepatic and peritoneal metastases but no local recurrence at the venotomy site.
  • Portal vein luminal stenosis occurred post-repair but was clinically insignificant.
  • Advanced CT imaging and 3D printed modeling significantly enhanced surgical planning and anatomical assessment.
  • Surgical excision achieved good short-term outcomes, and the dog was alive and euglycemic one year later despite metastatic disease.

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Multiple Choice Questions on this study

In Hertel 2025 et al., on portal venotomy for insulinoma, what was the duration of portal vein occlusion tolerated during surgery?

A. 10 minutes
B. 12 minutes
C. 15 minutes
D. 18 minutes
E. 20 minutes

Answer: 15 minutes

Explanation: The dog tolerated 15 minutes of portal vein occlusion without permanent complications.
In Hertel 2025 et al., on portal venotomy for insulinoma, what was the primary reason the authors selected portal venotomy instead of en bloc vessel resection?

A. To avoid splenectomy during tumor removal
B. To preserve regional lymph nodes and reduce morbidity
C. Because the thrombus was mobile and not firmly adhered to the vessel wall
D. To allow for complete resection of liver metastases
E. Because medical management failed

Answer: Because the thrombus was mobile and not firmly adhered to the vessel wall

Explanation: CT imaging and intraoperative palpation showed the thrombus was mobile, making direct venotomy feasible.
In Hertel 2025 et al., on portal venotomy for insulinoma, which postoperative complication was observed and medically managed?

A. Severe hemorrhage from the venotomy site
B. Pancreatitis
C. Portal hypertension
D. Thrombus recurrence
E. Splenic torsion

Answer: Pancreatitis

Explanation: Moderate pancreatitis was the only notable postoperative complication and was managed conservatively.
In Hertel 2025 et al., on portal venotomy for insulinoma, what was the dog's outcome one year postoperatively?

A. Alive with no signs of recurrence
B. Euthanized due to portal hypertension
C. Alive with metastatic disease and good quality of life
D. Died from acute pancreatitis
E. Alive but requiring constant-rate glucose infusion

Answer: Alive with metastatic disease and good quality of life

Explanation: The dog remained euglycemic and stable despite CT-confirmed metastasis at 6 months.
In Hertel 2025 et al., on portal venotomy for insulinoma, what material and technique were used to close the venotomy site?

A. 4–0 absorbable sutures in cruciate pattern
B. 5–0 polypropylene in simple continuous pattern reinforced with tissue glue
C. Surgical stapling device
D. 6–0 nylon interrupted sutures with omental patch
E. 5–0 polydioxanone in mattress pattern

Answer: 5–0 polypropylene in simple continuous pattern reinforced with tissue glue

Explanation: This closure method minimized bleeding and supported vascular integrity.

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