title: Surgical strategies for restoring liver arterial perfusion in pancreatic resections.
abstract: BACKGROUND
  Hepatic perfusion failure represents an important risk factor for severe complications and death after pancreatic resections. Arterial reconstruction could be required during pancreatic surgery because of tumor infiltration, benign strictures, or as a consequence of accidental arterial injury during dissection. All these situations can be faced with a certain frequency in high-volume pancreatic centers, where surgeons must be aware of the different alternatives to deal with these intricate scenarios.
  
  
  OBJECTIVE
  We herein describe the preoperative surgical planning as well as different surgical strategies for the restoration of arterial perfusion of the liver in pancreatic resections.
  
  
  CONCLUSIONS
  A thorough preoperative evaluation is essential for planning pancreatic surgery and preparing the surgeon and patient for potentially high complex procedures. The various therapeutic alternatives presented in this technical report might represent a good solution for selected patients with no other potentially curative option than surgery.
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina. martin.desantibanes@hospitalitaliano.org.ar.
authors.forename: Martin
authors.initials: M
authors.lastname: de Santibañes
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina.
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Alvarez
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina.
authors.forename: Oscar M
authors.initials: OM
authors.lastname: Mazza
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina.
authors.forename: Rodrigo Sanchez
authors.initials: RS
authors.lastname: Claria
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina.
authors.forename: Fanny Rodriguez
authors.initials: FR
authors.lastname: Santos
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina.
authors.forename: Claudio
authors.initials: C
authors.lastname: Brandi
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina.
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Santibañes
authors.affiliation: Department of General Surgery, Hospital Italiano de Buenos Aires, Argentina, Juan D. Perón 4190, C1181ACH, Buenos Aires, Argentina.
authors.forename: Juan
authors.initials: J
authors.lastname: Pekolj
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000601:surgery*; D005260:Female; D006499:Hepatic Artery / Q000601:surgery*; D006801:Humans; D008102:Liver Circulation / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000601:surgery*; D014656:Vascular Surgical Procedures
keywords: Hepatic artery reconstruction; Liver ischemia; Pancreatectomy; Pancreatic cancer; Postoperative complications; Vascular resection