# Peritoneal patch in portal vein reconstruction: Evaluating graft material outcomes in hepatopancreatobiliary and liver transplant surgery - A Systematic Review

## TL;DR

This systematic review compares peritoneal patches to synthetic grafts for portal vein reconstruction in liver and hepatopancreatobiliary surgeries, finding potential benefits but also complications.

## Contribution

The study evaluates the use of peritoneal patches as an alternative graft material for portal vein reconstruction, highlighting their potential advantages and limitations.

## Key findings

- Peritoneal patches provided effective intraoperative portal flow and patency.
- Complications like thrombosis and postoperative events were reported in some studies.
- PPs may offer lower immunogenic and thrombotic risks compared to synthetic grafts.

## Abstract

In hepatopancreatobiliary and liver transplant surgeries, portal vein repair is often needed. Peritoneal patches (PPs) might provide an advantage over synthetic grafts for portal vein reconstruction. The objective of this systematic review was to compare clinical outcomes, safety, and effectiveness of PPs versus conventional graft materials.

A comprehensive search of multiple databases such as PubMed, CINAHL EMBASE, SpringerLink Pakmedinet, and Google Scholar was conducted for studies focusing on portal vein repair using PPs. Eligible studies were case reports, case series, and retrospective studies from January 2000 to December 2024. Due to the heterogeneity of study designs and outcomes, a qualitative synthesis approach was applied.

Six studies were included. The studies reported a variety of surgical techniques and outcomes. Autologous peritoneal interposition grafts and PPs resulted in effective intraoperative portal flow and patency. Some studies, despite generally positive outcomes, reported complications such as thrombosis and significant postoperative events. A rigorous risk of bias assessment was not performed due to the limitations of the study design.

PPs may potentially be an alternative for portal vein reconstruction in HPB and LTx surgeries that offer benefits such as availability, adaptability, and lower immunogenic or thrombotic risks. These results should be confirmed with further research in the forms of prospective and comparative studies.