Aorta to proper hepatic artery bypass with total pancreatectomy and celiac axis resection (TP-CAR) in a patient with locally advanced pancreas adenocarcinoma

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved..

INTRODUCTION: Total pancreatectomy with en-bloc celiac axis resection (TP-CAR) and interposition graft placement between the aorta and the proper hepatic artery is a technically demanding, very uncommonly performed operation, even in high-volume pancreatic centers.

PRESENTATION OF CASE: We present, in clinical and technical detail, a patient with locally advanced adenocarcinoma of the pancreatic body and neck involving the celiac and common hepatic arteries and portal vein, who underwent neoadjuvant chemotherapy and radiation with very good response, followed by TP-CAR and aorto-proper hepatic artery bypass using saphenous vein graft. The patient had an uneventful intraoperative and postoperative course, short hospital stay, and histology consistent with a curative resection.

DISCUSSION: TP-CAR with common hepatic artery resection and proper hepatic artery reconstruction in patients with locally advanced pancreatic body cancer after appropriate neoadjuvant therapy can be performed safely and be potentially curative in centers with an established track record in advanced pancreatic surgery involving major peripancreatic vessels.

CONCLUSION: TP-CAR with proper hepatic artery reconstruction is a rare but potentially curative operation for selected patients with otherwise unresectable pancreatic adenocarcinoma.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:98

Enthalten in:

International journal of surgery case reports - 98(2022) vom: 30. Sept., Seite 107544

Sprache:

Englisch

Beteiligte Personen:

Tsiotos, Gregory G [VerfasserIn]
Ballian, Nikiforos [VerfasserIn]
Milas, Fotios [VerfasserIn]
Peraki, Evangelia [VerfasserIn]
Kostopanagiotou, Georgia [VerfasserIn]
Tsigaridas, Konstantinos [VerfasserIn]

Links:

Volltext

Themen:

Case Reports
Case report
Celiac artery resection
DP-CAR
Hepatic artery resection
Proper hepatic artery

Anmerkungen:

Date Revised 21.09.2022

published: Print-Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.1016/j.ijscr.2022.107544

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM345724011