A Case of Successful Stomach-Preserving Pancreaticoduodenectomy with Celiac Artery Resection after Neoadjuvant Chemoradiation Therapy for Pancreatic Cancer with Hepatic Arterial Variation

Yukie Kyakumoto, Masamichi Mizuma, Tomoya Abe, Tatsuyuki Takadate, Koji Fukase, Hideo Otsuka, Naoaki Sakata, Kei Nakagawa, Takanori Morikawa, Hiroki Hayashi, Takeshi Naito, Fuyuhiko Motoi, Atsushi Kanno, Toru Shimosegawa, Michiaki Unno

研究成果: Article査読

抄録

Here we report a case of successful stomach-preserving pancreaticoduodenectomy with celiac artery resection for pancreatic cancer with hepatic arterial variation. A 70-year-old woman was referred to our hospital for examination and treatment of pancreatic cancer. A CT scan showed a tumor with suspected portal vein invasion at the body and head of the pancreas, in contact with the common hepatic artery and the splenic artery with 360°involvement. Contact with the celiac artery and left gastric artery was less than1 80°. CT and angiography revealed hepatic arterial variation in which the right hepatic artery and the left hepatic artery arose from the superior mesenteric artery and the left gastric artery, respectively. Resectability status was considered as borderline resectable. After neoadjuvant chemoradiation therapy, the levels of the serum tumor markers declined remarkably and a CT scan showed SD(RECIST). Subtotal stomach-preserving pancreaticoduodenectomy with celiac artery resection(SSPPD-CAR)was performed without resectionof the left gastric artery and a pathological R0 resectionwas achieved. The significance of performing combination resection and reconstruction of a major artery in pancreatic cancer is unclear. However, there may be cases with vascular variants that enable radical resection without reconstruction of the common hepatic artery. Therefore, it is important to preoperatively evaluate the configuration of the artery accurately and to select the optimal surgical procedures onthe basis of these variations.

本文言語English
ページ(範囲)1966-1968
ページ数3
ジャーナルGan to kagaku ryoho. Cancer & chemotherapy
43
12
出版ステータスPublished - 2016 11 1

ASJC Scopus subject areas

  • 腫瘍学
  • 癌研究

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