We appreciate Dr Nghiem's interest in our recent article in the ARCHIVES titled “Superficial Femoral Vein as a Conduit for Portal Vein Reconstruction During Pancreaticoduodenectomy.” His comments are insightful and bring into focus our rationale for this surgical approach. Although we have not identified published literature describing the use of spiral vein grafts to replace the superior mesenteric and portal vein, it is a well-described approach for vein reconstruction for various indications and could possibly be applied in this setting.
Fleming JB, Barnett CC, Clagett GP. Spiral Vein Graft Replacement of Portomesenteric Vein Using Saphenous Vein—Reply. Arch Surg. 2006;141(2):217–218. doi:10.1001/archsurg.141.2.217-c
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