Successful pancreaticoduodenectomy for pancreatic cancer with an aberrant hepatic artery following hepatic arterial alteration by selective embolization: A case report

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  • 肝動脈走行変異を伴う膵頭部癌に対し術前に血管塞栓術を行い安全に亜全胃温存膵頭十二指腸切除術を施行した1例

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Abstract

<p>A 53-year-old man was diagnosed pancreatic head cancer. Abdominal CT scan revealed a low density area in the head of pancreas. A common hepatic artery was not identified; instead, a right hepatic artery (RHA) originating from the superior mesenteric artery (SMA) passing through the parenchyma of the pancreas head was seen. Before surgery, we performed balloon-obstruction of the RHA in the pancreatic head. Then, we observed an enlarged communicating artery to the RHA from the left hepatic artery via the left gastric artery. Finally, we performed embolization of RHA in the pancreatic head. Twenty-two days later, the patient successfully underwent subtotal stomach-preserving pancreaticoduodenectomy. In the surgical treatment of pancreatic cancer, both pursuing radical resection and preserving organ blood flow are important. In the current case, we recognized the aberrant hepatic artery through the parenchyma of the pancreatic head by preoperative imaging and altered hepatic blood flow by embolization. We were able to perform surgery safely without sacrificing curability.</p>

Journal

  • Suizo

    Suizo 31 (4), 679-687, 2016

    Japan Pancreas Society

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