Pancreatoduodenectomy in a patient with celiac axis stenosis and a replaced common hepatic artery: A case report

被引:2
作者
Komatsubara, Takashi [1 ]
Fujimoto, Koji [1 ]
Tanigawa, Yuma [1 ]
Mitsuoka, Eisei [1 ]
Isii, Masayuki [1 ]
机构
[1] Shinko Hosp, Dept Surg, 1-4-47 Wakihama Cho,Chuo Ku, Kobe, Hyogo 6510072, Japan
关键词
Celiac axis stenosis; Indocyanine green fluorescence imaging; Pancreatoduodenectomy; Replaced common hepatic artery; Case report; MANAGEMENT; ANATOMY; PRESERVATION; OCCLUSION;
D O I
10.1016/j.ijscr.2022.107088
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Evaluation of anatomical variations is important in pancreatoduodenectomy (PD) because an arterial anomaly is a risk factor for morbidity. Herein, we report a rare case of PD for lower bile duct cancer in which celiac axis stenosis and a replaced common hepatic artery (rCHA) coexisted. Presentation of case: An 84-year-old woman presented with epigastric pain. She was diagnosed with a lower bile duct cancer and underwent PD. Preoperative computed tomography showed celiac axis stenosis, and the deformed celiac artery had a "hooked appearance," suggesting compression by the median arcuate ligament (MAL). The rCHA branched from the superior mesenteric artery. The gastroduodenal artery (GDA) diverged from the rCHA, forming a developed arterial arcade of the pancreatic head. There was an oncological safety margin between the rCHA and common bile duct; however, a part of the collateral artery was close to the common bile duct. Therefore, we planned to preserve the rCHA and resect the GDA to form collateral circulation. The MAL was divided and we evaluated the blood flow of the left upper abdominal organs using indocyanine green fluorescence imaging with a near-infrared camera system. We considered that perfusion of organs was preserved, and PD was performed without vessel reconstruction. No ischemic complication occurred in the postoperative course. Discussion: The coexistence of these arterial anomalies made the procedure of PD more complicated. Conclusion: Precise preoperative diagnosis of arterial anomalies is necessary to avoid postoperative complications that may be induced by intraoperative arterial injury and organ ischemia.
引用
收藏
页数:5
相关论文
共 50 条
[21]   Successful treatment of a common hepatic artery pseudoaneurysm using a coronary covered stent following pancreatoduodenectomy: report of a case [J].
Asai, Koji ;
Watanabe, Manabu ;
Kusachi, Shinya ;
Matsukiyo, Hiroshi ;
Saito, Tomoaki ;
Kodama, Hajime ;
Enomoto, Toshiyuki ;
Nakamura, Yoichi ;
Okamoto, Yasushi ;
Saida, Yoshihisa ;
Iijima, Raisuke ;
Nagao, Jiro .
SURGERY TODAY, 2014, 44 (01) :160-165
[22]   Successful treatment of a common hepatic artery pseudoaneurysm using a coronary covered stent following pancreatoduodenectomy: report of a case [J].
Koji Asai ;
Manabu Watanabe ;
Shinya Kusachi ;
Hiroshi Matsukiyo ;
Tomoaki Saito ;
Hajime Kodama ;
Toshiyuki Enomoto ;
Yoichi Nakamura ;
Yasushi Okamoto ;
Yoshihisa Saida ;
Raisuke Iijima ;
Jiro Nagao .
Surgery Today, 2014, 44 :160-165
[23]   Case report: a case of masked subclavian artery stenosis in a haemodialysis patient [J].
Tezuka, Ayako ;
Kobayashi, Masatake ;
Ito, Ryosuke ;
Murata, Naotaka ;
Satomi, Kazuhiro .
EUROPEAN HEART JOURNAL-CASE REPORTS, 2024, 8 (11)
[24]   A large common hepatic artery pseudo aneurysm: A case report [J].
Charo, Dilawer ;
Al Naser, Qutaiba ;
Shawach, Saleh ;
Al Ali, Alhamza .
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 2023, 113
[25]   Aberrant arc between the common hepatic artery and a replaced right hepatic artery resulting in misperfusion in a patient with a hepatic arterial infusion pump [J].
Hasan, Omar ;
Greco, Stephanie ;
Kennedy, Timothy ;
Carpizo, Darren ;
Kempf, Jeffrey ;
Nosher, John .
SURGICAL AND RADIOLOGIC ANATOMY, 2019, 41 (03) :355-358
[26]   A gastrosplenic trunk in association with a replaced common hepatic artery arising independently from the superior mesenteric artery: A case report using multidetector computed tomography angiography [J].
Bolintineanu, Laura-Andreea ;
Iacob, Nicoleta ;
Matusz, Petru ;
Pusztai, Agneta Maria .
JOURNAL OF THE ANATOMICAL SOCIETY OF INDIA, 2019, 68 (04) :312-315
[27]   Pancreaticoduodenectomy with Replaced Common Hepatic Artery and Portal Vein Reconstruction in Primary Carcinoma Duodenum: a Case Report and Literature Review [J].
Desai, Gunjan S. ;
Pande, Prasad ;
Shah, Rajiv C. ;
Jagannath, Palepu .
JOURNAL OF GASTROINTESTINAL CANCER, 2019, 50 (03) :684-688
[28]   Emergency Pancreaticoduodenectomy for Bleeding Pancreatic Pseudoaneurysm in Patient with Common Mesentery and Replaced Right Hepatic Artery [J].
Lupascu, C. ;
Ursulescu, C. ;
Andronic, D. .
CHIRURGIA, 2013, 108 (06) :910-914
[29]   Collaterals management during pancreatoduodenectomy in patients with celiac axis stenosis: A systematic review of the literature [J].
Giovanardi, Francesco ;
Lai, Quirino ;
Garofalo, Manuela ;
Murillo, Gabriela A. Arroyo ;
de Janvry, Eleonore Choppin ;
Hassan, Redan ;
Laureiro, Zoe Larghi ;
Consolo, Adriano ;
Melandro, Fabio ;
Berloco, Pasquale B. .
PANCREATOLOGY, 2018, 18 (05) :592-600
[30]   Rare Variant of the Replaced Common Hepatic Artery During Pancreaticoduodenectomy [J].
Michael Rousek ;
Pavel Zaruba ;
Miroslav Ryska ;
Radek Pohnan .
Indian Journal of Surgery, 2022, 84 :510-512