title: [Arterial reconstruction in pancreatic carcinoma –demonstration of surgical techniques].
abstract: BACKGROUND
  For a highly selected group of patients, a complete resection (R0) of a pancreatic carcinoma including arterial resection and reconstruction can represent an advantage in survival. The expertise of the surgeon in vascular and pancreatic surgery as well as the proficiency of the entire surgical and anaesthesiological team and the appropriate infrastructure of the hospital are prerequisites for the success of such complex operations. Proximal and distal of the tumour, sufficient lengths of the vessels are needed for the vascular anastomoses. In this video, the principles of arterial resection and reconstruction are shown in two patients with advanced pancreatic carcinoma.
  
  
  METHODS
  This procedure is indicated for locally advanced pancreatic carcinoma with arterial infiltration without distant metastasis after neoadjuvant therapy.
  
  
  METHODS
  The procedure involves 2 steps: 1. pancreatic head resection with resection of the common hepatic artery and end-to-end anastomosis of the hepatic artery and portal vein resection; 2. left pancreatic resection including splenectomy; resection of the celiac trunk, the superior mesenteric artery; reinsertion of the superior mesenteric artery into the aorta; end-to-end anastomosis of the common hepatic artery with the stump of the celiac trunk.
  
  
  CONCLUSIONS
  Given the appropriate experience, technically demanding arterial resections and reconstructions in pancreatic carcinoma are feasible and can provide superior survival for the patient compared to palliative therapy.
authors: Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden, Deutschland.
authors: R
authors: R
authors: Grützmann
authors: Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, RKK Klinikum - St. Josefskrankenhaus, Freiburg, Deutschland.
authors: S
authors: S
authors: Kersting
authors: Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden, Deutschland.
authors: M
authors: M
authors: Distler
authors: Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Carl Gustav Carus Dresden, Deutschland.
authors: J
authors: J
authors: Weitz
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D021441:Carcinoma, Pancreatic Ductal / Q000098:blood supply* / Q000601:surgery*; D002445:Celiac Artery / Q000473:pathology* / Q000601:surgery*; D059186:Chemoradiotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D006499:Hepatic Artery / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D010179:Pancreas / Q000098:blood supply* / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D010193:Pancreaticojejunostomy; D011169:Portal Vein / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed