title: Hepatopancreatoduodenectomy with arterial reconstruction for extrahepatic cholangiocarcinoma with celiac axis obstruction: report of a case.
abstract: We report a case of successful right hepatectomy plus pancreatoduodenectomy (Rt-HPD) with arterial reconstruction for extrahepatic bile duct carcinoma with obstruction of the celiac axis in a 76-year-old man. Obstruction of the celiac axis resulted in arterial blood supply to the upper abdominal organs coming from the pancreatic head arcade. The patient underwent arterial reconstruction before the Rt-HPD to maintain the blood supply from the pancreatic head arcade for as long as possible. His postoperative course was uneventful and he was well with no sign of recurrence when last seen, 64 months after surgery. To our knowledge, this is the first description of this modified HPD with arterial reconstruction. Thus, rational surgical planning based on careful preoperative assessment would expand the indications for HPD, even for patients with celiac axis obstruction requiring arterial reconstruction.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan, nakagawa13101975@yahoo.co.jp.
authors.forename: Akifumi
authors.initials: A
authors.lastname: Nakagawa
authors.forename: Gen
authors.initials: G
authors.lastname: Sugawara
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ebata
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Igami
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shingu
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001650:Bile Duct Neoplasms / Q000098:blood supply* / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D002445:Celiac Artery / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000098:blood supply* / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008297:Male; D010179:Pancreas / Q000098:blood supply; D016577:Pancreaticoduodenectomy / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*