title: Liver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy.
abstract: Reported here are two cases of a modified Appleby operation for borderline resectable ductal adenocarcinoma of the pancreatic body, in one of which a R0 distal resection was attended to by excision, not only of the celiac axis, but also of the common and left hepatic arteries in the presence of arterial anatomic variation Michels, type VIIIb. The possibility and avenues of the maintenance of the blood supply to the left hepatic lobe after surgical aggression of this kind are demonstrated employing computed tomography (CT) and 3-D CT angiography. Furthermore, both cases highlight all important worrisome aspects of pancreatic cancer resectability prediction.
authors.affiliation: Vyacheslav I Egorov, Ostroumov 14 City Hospital, Department of Surgical Oncology, Sechenov First State Medical University, 117997 Moscow, Russia.
authors.forename: Vyacheslav I
authors.initials: VI
authors.lastname: Egorov
authors.forename: Roman V
authors.initials: RV
authors.lastname: Petrov
authors.forename: Michail V
authors.initials: MV
authors.lastname: Lozhkin
authors.forename: Olga A
authors.initials: OA
authors.lastname: Maynovskaya
authors.forename: Natalia S
authors.initials: NS
authors.lastname: Starostina
authors.forename: Natalia R
authors.initials: NR
authors.lastname: Chernaya
authors.forename: Ekaterina M
authors.initials: EM
authors.lastname: Filippova
keywords: Blood supply; Cancer; Computed tomography; Distal pancreatectomy; Management; Pancreas; Pancreatectomy; Vascular invasion
references.citation: Br J Surg. 2004 May;91(5):586-94
references.pmid: 15122610
references.citation: Radiology. 1998 Oct;209(1):121-8
references.pmid: 9769822
references.citation: Radiology. 1998 Feb;206(2):373-8
references.pmid: 9457188
references.citation: Curr Treat Options Gastroenterol. 2005 Oct;8(5):377-84
references.pmid: 16162303
references.citation: World J Surg. 2006 Jun;30(6):976-82; discussion 983-4
references.pmid: 16736324
references.citation: J Gastrointest Surg. 2007 Jun;11(6):743-9
references.pmid: 17417712
references.citation: Br J Surg. 1998 Feb;85(2):202-7
references.pmid: 9501816
references.citation: Radiology. 2005 Oct;237(1):361-5
references.pmid: 16118153
references.citation: Hepatobiliary Pancreat Dis Int. 2003 Nov;2(4):622-5
references.pmid: 14627533
references.citation: J Magn Reson Imaging. 2000 Aug;12(2):261-8
references.pmid: 10931589
references.citation: J Int Coll Surg. 1953 Aug;20(2):133-48
references.pmid: 13084954
references.citation: Hepatogastroenterology. 2000 Nov-Dec;47(36):1526-30
references.pmid: 11148993
references.citation: JOP. 2001 May;2(3):93-7
references.pmid: 11870330
references.citation: J Gastrointest Surg. 2005 Jan;9(1):22-8; discussion 28-9
references.pmid: 15623441
references.citation: Surg Radiol Anat. 2000;22(1):41-5
references.pmid: 10863746
references.citation: Cancer. 1953 Jul;6(4):704-7
references.pmid: 13059764
references.citation: Radiology. 2003 Jul;228(1):246-50
references.pmid: 12738876
references.citation: Ann Surg. 1999 May;229(5):693-8; discussion 698-700
references.pmid: 10235528
references.citation: Radiology. 1975 Oct;117(1):49-54
references.pmid: 1162072
references.citation: J Hepatobiliary Pancreat Surg. 2004;11(6):402-8
references.pmid: 15619016
references.citation: Ann Surg. 2002 Nov;236(5):676-83
references.pmid: 12409675
references.citation: World J Surg. 2003 Mar;27(3):324-9
references.pmid: 12607060
references.citation: J Surg Oncol. 2005 Jul 1;91(1):33-40
references.pmid: 15999356
references.citation: AJR Am J Roentgenol. 2004 Feb;182(2):419-25
references.pmid: 14736675
references.citation: Cancer. 1996 Jun 1;77(11):2240-5
references.pmid: 8635090
references.citation: Surg Clin North Am. 2001 Jun;81(3):595-610
references.pmid: 11459274
references.citation: J Hepatobiliary Pancreat Surg. 2000;7(2):183-7
references.pmid: 10982611
references.citation: Hepatogastroenterology. 1997 Mar-Apr;44(14):387-93
references.pmid: 9164507
references.citation: Aust N Z J Surg. 1999 Nov;69(11):816-20
references.pmid: 10553973
references.citation: Cancer Control. 2008 Oct;15(4):295-307
references.pmid: 18813197
references.citation: Lancet. 2000 Sep 9;356(9233):909-10
references.pmid: 11036898
references.citation: AJR Am J Roentgenol. 2002 Sep;179(3):717-24
references.pmid: 12185052
references.citation: J Gastrointest Surg. 2004 Dec;8(8):935-49; discussion 949-50
references.pmid: 15585381
references.citation: Hepatogastroenterology. 1999 Nov-Dec;46(30):3257-62
references.pmid: 10626197
references.citation: Am J Surg. 1966 Sep;112(3):337-47
references.pmid: 5917302
references.citation: Langenbecks Arch Surg. 2003 Apr;388(2):101-6
references.pmid: 12684805
references.citation: J Surg Oncol. 2000 Apr;73(4):212-8
references.pmid: 10797334
references.citation: J Comput Assist Tomogr. 2005 Mar-Apr;29(2):170-5
references.pmid: 15772532
references.citation: J Gastrointest Surg. 2000 Nov-Dec;4(6):567-79
references.pmid: 11307091
references.citation: Cancer. 1995 Apr 15;75(8):2069-76
references.pmid: 7697596
references.citation: Hepatogastroenterology. 2005 Jul-Aug;52(64):1090-1
references.pmid: 16001636
references.citation: Radiology. 1970 Mar;94(3):575-9
references.pmid: 5413898
references.citation: Radiology. 1982 Aug;144(3):485-94
references.pmid: 6285413
references.citation: Radiology. 1995 Nov;197(2):381-5
references.pmid: 7480681
references.citation: World J Surg. 2003 Oct;27(10):1075-84
references.pmid: 12925907
references.citation: Ann Surg. 1984 Apr;199(4):418-25
references.pmid: 6712317
references.citation: J Gastrointest Surg. 2005 Apr;9(4):503-7
references.pmid: 15797231
references.citation: Radiology. 2000 Feb;214(2):491-5
references.pmid: 10671598
references.citation: Radiology. 2002 Jul;224(1):34-41
references.pmid: 12091659
references.citation: Radiology. 1980 May;135(2):295-9
references.pmid: 7367615
references.citation: World J Surg. 1999 Sep;23(9):913-9
references.pmid: 10449820
references.citation: Surg Today. 2008;38(11):1021-8
references.pmid: 18958561
references.citation: Clin Anat. 1999;12(4):245-9
references.pmid: 10398383
references.citation: Radiology. 1995 May;195(2):327-32
references.pmid: 7724748
references.citation: Abdom Imaging. 1996 May-Jun;21(3):202-6
references.pmid: 8661548
references.citation: Int J Pancreatol. 1997 Aug;22(1):15-21
references.pmid: 9387020
references.citation: Am J Surg. 1994 Jan;167(1):104-11; discussion 111-3
references.pmid: 7906097
references.citation: Am J Surg. 2006 Sep;192(3):330-5
references.pmid: 16920427