TIGRESS Survey

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1. If you are happy to, please provide the name of your institution.This is optional.
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2. How many pancreatic resections would you estimate your unit performs each year?* This field is required.Please include all types of pancreatic resection and all indications.
Less than 50
51-100
More than 100
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3a. How many pancreatic resections would you estimate your unit performs each year where a venous resection is also performed?* This field is required.Please include all cases where patients undergo a pancreatic resection (any kind) with concomitant resection of a named vein.
Less than 5
6-10
More than 10
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3b. Following a "side-bite" resection of a vein, in which situations would you use a patch for the repair (rather than primary closure)?Here a "side-bite" refers to a tangential venous resection performed where the tumour involves up to one third of the vein circumference. Please type your answer. If you would typically elect to just perform a formal resection in this scenario, feel free to skip this question (an answer is not required).
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4. If you routinely perform "side-bite" resections, which type of patch would you typically use?* This field is required.Here a "side-bite" refers to a tangential venous resection performed where the tumour involves up to one third of the vein circumference. Please select the one option which best reflects your unit.
Synthetic patch
Autologous vein patch
Bovine pericardial patch
Peritoneum
Other
We do not routinely use patches
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5. What "other" kind of patch would you use to repair a "side-bite" defect?Please type your answer.
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6. At your unit, when you formally resect a segment of vein, how do you typically perform the reconstruction?* This field is required.Please select the option most commonly performed at your unit.
End-to-end reconstruction with interposition graft
End-to-end reconstruction with no graft
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7. Which type of graft would you most commonly use when performing a reconstruction?* This field is required.Please select the one option which best reflects your unit.
Autologous vein
Synthetic graft
Peritoneal segment
Cadaver graft
Other
We do not typically use grafts
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8. Which "other" type of graft would you use when performing a reconstruction?Please type your answer.
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9. When an autologous venous graft is required, which harvest site would you most commonly use?* This field is required.Please select the one option which best reflects your unit.
Internal jugular vein
Left renal vein
Gonadal vein
Other
We do not routinely use autologous venous grafts
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10. When using a prosthetic graft, which material would you most commonly use?* This field is required.Please select the one option which best reflects your unit.
Dacron
PTFE
Other
We do not routinely use prosthetic grafts
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11. Do you routinely administer a heparin bolus before starting a venous reconstruction?* This field is required.
YESNO
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12. Do you routinely occlude SMA inflow whilst fashioning a venous anastomosis in order to prevent congestion and intestinal oedema?* This field is required.
YESNO
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13. Following a venous resection and reconstruction, do you routinely perform a CT scan in the postoperative phase?* This field is required.
YESNO
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14. When would you typically perform this CT scan?Please type your answer.
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15. In which of these scenarios would you routinely provide therapeutic dose anticoagulation therapy?* This field is required.Please only select the option(s) which include techniques you would routinely use.
A patient who has undergone a "side-bite" resection with primary closure
A patient who had undergone a "side-bite" resection with a patch repair
A patient who has received a prosthetic interposition graft
A patient who has received an autologous interposition graft
A patient who has undergone an end-to-end anastomosis without graft
None of these scenarios
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16. Which of these anticoagulant therapies would you typically provide?Please tick all that apply.
IV heparin followed by an oral anticoagulant
Low molecular weight heparin followed by an oral anticoagulant
Oral anticoagulant alone (with or without "bridging" therapy)
Other
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17. How long would you typically provide anticoagulation for?Here we are referring to patients who have NOT had a scan which suggests there is PV/SMV thrombosis.
For the duration of the hospital stay only
3 months
6 months
Other
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18. If you identify portal vein/SMV thrombosis in a patient who has undergone pancreatic surgery with venous resection, how would your management change?Please select the one option which best reflects practice in your unit.
The patient would already be on anticoagulation therapy but I would switch to a different anticoagulant
The patient would be on prophylactic anticoagulation so I would switch this to a therapeutic dose
The patient would already be on anticoagulation therapy so I wouldn't change anything
Other
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19. Would you be interested in participating in a randomised controlled trial which compares therapeutic anticoagulation to no anticoagulation following pancreatic surgery with venous resection?* This field is required.We would like to gauge interest before proposing a study.
YESNO
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