Modified Appleby operation in treatment of distal pancreatic cancer.
OBJECTIVE
To introduce our experience with modified Appleby operation in the treatment of a patient with advanced carcinoma of the body and tail of the pancreas, which invaded the common hepatic, splenic and celiac arteries.


METHODS
The celiac artery was ligated at its start point, and distal pancreas and involved arteries were resected en bloc. Pyloric and right gastroepiploic arteries should be preserved to keep blood supply to the stomach and pulsation of the proper hepatic artery be felt after occlusion of the common hepatic artery.


RESULTS
The patient was free from epigastric and back pain after the operation, although she died of liver metastasis after seven months. CT scan did not show local reccurrence before her death.


CONCLUSIONS
This procedure can increase the resectability and radical extent of locally advanced cancer of the body and tail of the pancreas and offer patients a better quality of life.
Liu
Bin
B
Department of General Surgery, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China. liubinxy@hotmail.com
D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D000368:Aged; D001707:Biopsy, Needle; D002445:Celiac Artery / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006499:Hepatic Artery / Q000473:pathology / Q000601:surgery; D006801:Humans; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D018570:Risk Assessment; D013157:Splenic Artery / Q000473:pathology / Q000601:surgery; D013997:Time Factors