title: Total pancreatectomy with en bloc celiac axis resection for a pancreatic adenocarcinoma involving both the gastroduodenal artery and the celiac artery.
abstract: A pancreatic adenocarcinoma involving both the celiac artery and the gastroduodenal artery is often considered to be unresectable because the simultaneous division of both arteries may result in an acute severe ischemia of the liver and the stomach. We report here a case of total pancreatectomy with en bloc celiac axis resection for a 61-year-old female with a pancreatic adenocarcinoma involving both the celiac artery and the gastroduodenal artery. The patient had a replaced right hepatic artery from the superior mesenteric artery and a replaced left hepatic artery from the left gastric artery, which was directly arising from the aorta. Preserving these collateral arteries, neither hepatic artery reconstruction nor total gastrectomy was needed after resection. The reported incidence of similar arterial anatomy was only 0.2% but the precise evaluation of arterial anatomy is important to offer a chance of curative resection for patients with usually unresectable locally advanced pancreatic cancer.
authors.affiliation: National Cancer Center Hospital, Tokyo, Japan. sanara@ncc.go.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nara
authors.forename: Seiji
authors.initials: S
authors.lastname: Oguro
authors.forename: Shojiro
authors.initials: S
authors.lastname: Hata
authors.forename: Yoji
authors.initials: Y
authors.lastname: Kishi
authors.forename: Minoru
authors.initials: M
authors.lastname: Esaki
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shimada
authors.forename: Tomoo
authors.initials: T
authors.lastname: Kosuge
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D002445:Celiac Artery / Q000473:pathology / Q000601:surgery*; D002447:Celiac Plexus / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*