[A safely resected case of hypervascular pancreatic giant tumor after preoperative arterial embolization].
A 73-year-old woman visited our hospital for a treatment of pancreatic tumor that increased steadily in size of 6 cm in diameter in 1999 to 13 cm in 2008, while remaining in asymptomatic condition throughout this follow-up time. The tumor was big and flowed from many vessels such as portal and superior mesenteric veins and the celiac and superior mesenteric arteries. These were critical for determining tumor respectability and the risk of massive intra-operative hemorrhage was felt to be considerable. Therefore, preoperative embolization of the tumor-feeding arteries arising from the celiac axis (gastroduodenal, splenic and dorsal pancreatic arteries) was performed on the previous day of operation. Tumor resection with pancreaticoduodenectomy and partial resection of portal vein and reconstruction were performed. We got to SMA with the use of "paraduodenal mesenteric approach", we called, and we finished the operation without a blood transfusion. The final pathology confirmed the diagnosis of serous microcystic adenoma.
Dept. of Gastroenterologic Surgery, Division of Cancer Medicine, Graduate School of Medicine Science, Kanazawa University.
Atsushi
A
Hirose
Hidehiro
H
Tajima
Koichi
K
Okamoto
Isamu
I
Makino
Jun
J
Kinoshita
Hironori
H
Hayashi
Keishi
K
Nakamura
Katsunobu
K
Oyama
Hisatoshi
H
Nakagawara
Masafumi
M
Inokuchi
Hideto
H
Fujita
Hiroyuki
H
Takamura
Itasu
I
Ninomiya
Hirohisa
H
Kitagawa
Sachio
S
Fushida
Takashi
T
Tani
Takashi
T
Fujimura
Tetsuo
T
Ohta
Wataru
W
Koda
Osamu
O
Matsui
D000236:Adenoma; D000368:Aged; D018293:Cystadenoma, Serous / Q000098:blood supply / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D009389:Neovascularization, Pathologic / Q000628:therapy*; D010190:Pancreatic Neoplasms / Q000098:blood supply / Q000473:pathology / Q000601:surgery* / Q000628:therapy