title: [A case of pancreaticoduodenectomy for duodenal carcinoma with a replaced common hepatic artery running through the pancreatic parenchyma].
abstract: To perform safe and radical pancreaticoduodenectomy, adequate knowledge of the branching and running course of the common hepatic artery is necessary. Formation of a common trunk by the common hepatic artery and superior mesenteric artery, called the hepatomesenteric trunk, is very rare. When it occurs, the common hepatic artery arising from the hepatomesenteric trunk usually runs behind the pancreas head. In the present case, however, it ran through the pancreatic parenchyma. Therefore, pancreaticoduodenectomy for duodenal carcinoma was performed with preservation of the intrapancreatic common hepatic artery. When pancreaticoduodenectomy is performed in patients with a replaced common hepatic artery running through the pancreatic parenchyma, it is necessary to preoperatively determine whether to preserve or resect the common hepatic artery in the pancreas with consideration of the curability. If resected, whether to reconstruct it must also be determined. If reconstructed, the reconstruction method must be determined, and if not, it is important to perform preoperative coiling of the common hepatic artery and intraoperative measurement of the hepatic blood flow with a Doppler flow meter.
authors.affiliation: Dept. of General Surgery, Chiba University Graduate School of Medicine, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Hosokawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimizu
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nakajima
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: Satoshi
authors.initials: S
authors.lastname: Kuboki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Suzuki
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D004379:Duodenal Neoplasms / Q000098:blood supply / Q000601:surgery*; D006499:Hepatic Artery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000601:surgery*; D010179:Pancreas / Q000098:blood supply*; D016577:Pancreaticoduodenectomy