title: [A case of cholangiocarcinoma with hepatomesenteric trunk and intestinal malrotation treated with pancreaticoduodenectomy].
abstract: The patient was a 61-year-old man. He was underwent pancreaticoduodenectomy for common bile duct cancer. The preoperative dynamic CT revealed that hepatic artery was branched from the superior mesenteric artery, run through pancreatic surface caudal to cranial and flowed into liver. And this vessel had several branches into pancreas. In operation, to ensure blood flow to the liver, hepatic artery was detached from pancreas by cutting off branches into pancreas. In addition, intestinal malrotation was also confirmed (Treitz ligament was not formed and small intestine was present in the right side of abdominal space, while colon was present in the other side). Performing a pancreatoduodenectomy for malignant tumors, it is very important to recognize the variation of hepatic artery, because of the necessity for the consideration of blood flow to the liver. In this case, we indicated a preservation of hepatic artery with adequate lymph node dissection.
authors.affiliation: Dept. of General Surgery, Graduate School of Medicine, Chiba University.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hayashi
authors.forename: Shigetsugu
authors.initials: S
authors.lastname: Takano
authors.forename: Fumio
authors.initials: F
authors.lastname: Kimura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshidome
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kato
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Yoshitomi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Furukawa
authors.forename: Dan
authors.initials: D
authors.lastname: Takeuchi
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takayashiki
authors.forename: Kosuke
authors.initials: K
authors.lastname: Suda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuboki
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000601:surgery*; D006499:Hepatic Artery / Q000002:abnormalities*; D006801:Humans; D007422:Intestines / Q000002:abnormalities*; D008297:Male; D008638:Mesenteric Arteries / Q000002:abnormalities*; D008875:Middle Aged; D016577:Pancreaticoduodenectomy