title: Modified Appleby operation in treatment of distal pancreatic cancer.
abstract: 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.
authors: Department of General Surgery, Affiliated Hospital of Xuzhou Medical College, Xuzhou 221002, China. liubinxy@hotmail.com
authors: Bin
authors: B
authors: Liu
mesh_terms: 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