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Pancreaticoduodenectomy with Preservation of Collateral Circulation or Revascularization for Biliary Pancreatic Cancer with Celiac Axis Occlusion : A Report of 2 Cases

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Title: Pancreaticoduodenectomy with Preservation of Collateral Circulation or Revascularization for Biliary Pancreatic Cancer with Celiac Axis Occlusion : A Report of 2 Cases
Authors: Shibuya, Kazuaki Browse this author
Kamachi, Hirofumi Browse this author →KAKEN DB
Orimo, Tatsuya Browse this author
Nagatsu, Akihisa Browse this author
Shimada, Shingo Browse this author
Wakayama, Kenji Browse this author
Yokoo, Hideki Browse this author →KAKEN DB
Kamiyama, Toshiya Browse this author →KAKEN DB
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: Biliary Tract Neoplasms
Celiac Disease
Pancreatic Neoplasms
Pancreaticoduodenectomy
Issue Date: 9-Apr-2018
Publisher: International Scientific Information
Journal Title: The American journal of case reports
Volume: 19
Start Page: 413
End Page: 420
Publisher DOI: 10.12659/AJCR.908516
Abstract: Objective: Unusual setting of medical care Background: In cases of celiac axis occlusion requiring pancreaticoduodenectomy for malignancy, both oncologic curability and control of hepatic arterial flow must be considered, but the operative strategy is undeveloped. Case Reports: Case 1: A 74-year-old man was diagnosed with hilar cholangiocarcinoma with celiac axis stenosis. The collateral from the superior mesenteric artery ran through the pancreas head but no invasion was observed in preoperative imaging. Hepatopancreatoduodenectomy with preservation of a collateral was performed. Case 2: A 69-year-old woman was diagnosed with pancreas head cancer with celiac axis occlusion. The collateral from the superior mesenteric artery ran through pancreas head and tumor invasion was observed. Pancreaticoduodenectomy with bypass revascularization using a vein graft was performed. Both operations were performed safely oncologically under preoperative planning that was based on computed tomographic angiography. The operative procedure was ultimately determined by evaluation of perioperative blood flow under Doppler ultrasonography after clamping the gastroduodenal artery. Conclusions: Preoperative simulations of arterial revascularization and perioperative evaluation of blood flow are necessary for the success of this procedure.
Rights: https://creativecommons.org/licenses/by-nc-nd/4.0/
Type: article
URI: http://hdl.handle.net/2115/70890
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 蒲池 浩文

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