Führen in reduzierter Arbeitszeit: Chancen und Risiken für die Personalarbeit der Zukunft

Ein Team leiten und nicht in Vollzeit arbeiten? Das halten viele noch für unvereinbar. Doch mit Blick auf sich verändernde Rahmenbedingungen und Bedürfnisse am Arbeitsmarkt erfährt Führung in reduzierter Arbeitszeit immer mehr Beachtung in Unternehmen und Organisationen

Splenorenal shunt for reconstruction of the gastric and splenic venous drainage during pancreatoduodenectomy with resection of the portal venous confluence

Background!#!Resection of the portal venous confluence is frequently necessary for radical resection during pancreatoduodenectomy for cancer. However, ligation of the splenic vein can cause serious postoperative complications such as gastric/splenic venous congestion and left-sided portal hypertension. A splenorenal shunt (SRS) can maintain gastric and splenic venous drainage and mitigate these complications.!##!Purpose!#!This study describes the surgical technique, postoperative course, and surgical outcomes of SRS after pancreatoduodenectomy.!##!Methods!#!Ten patients who underwent pancreatoduodenectomy and SRS between September 2017 and April 2019 were evaluated. After resection an end-to-side anastomosis between the splenic vein and the left renal vein was performed. Postoperative shunt patency, splenic volume, and any SRS-related complications were recorded.!##!Results!#!The rates of short- and long-term shunt patency were 100% and 60%, respectively. No procedure-associated complications were observed. No signs of left-sided portal hypertension, such as gastrointestinal bleeding or splenomegaly, and no gastric/splenic ischemia were observed in patients after SRS.!##!Conclusion!#!SRS is a safe and effective measure to mitigate gastric congestion and left-sided portal hypertension after pancreatoduodenectomy with compromised gastric venous drainage after resection of the portal venous confluence