scholarly journals Radical antegrade modular pancreatosplenectomy for adenocarcinomaof the body of the pancreas in a patient with portal annular pancreas, aberrant hepatic artery, and absence of the celiac trunk

Medicine ◽  
2017 ◽  
Vol 96 (48) ◽  
pp. e8738
Author(s):  
Hao Yuan ◽  
Pengfei Wu ◽  
Jianmin Chen ◽  
Zipeng Lu ◽  
Lei Chen ◽  
...  
2016 ◽  
Vol 101 (11-12) ◽  
pp. 550-553
Author(s):  
Ippei Matsumoto ◽  
Keiko Kamei ◽  
Shumpei Satoi ◽  
Takuya Nakai ◽  
Yoshifumi Takeyama

Portal annular pancreas (PAP) is an asymptomatic congenital pancreatic anomaly in which the uncinate process of the pancreas extends and fuses to the dorsal surface of the body of the pancreas by surrounding the portal vein and or the superior mesenteric vein. During pancreaticoduonectomy (PD), the presence of PAP significantly increased risk for postoperative pancreatic fistula (POPF) because specific management of 2 pancreatic resection planes with 1 or 2 pancreatic ducts is required for pancreatico-intestinal reconstruction. To reduce the risk of POPF, a shift of the resection plain to the left for 1 anastomosis is recommended. We report a case of PAP that was successfully performed PD with pancreaticogastrostomy (PG). PG was conducted with invagination of the 2 resected pancreatic planes together into the stomach to minimize resected volume of the pancreas. A 78-year-old male patient with PAP underwent PD due to a duodenal adenocarcinoma. Intraoperatively, the uncinate process extended extensively behind the portal vein and fused with the dorsal surface of the pancreatic body above the splenic vein. For pancreatico-intestinal reconstruction, PG was performed with invagination of the 2 resected pancreatic planes together into the stomach. The postoperative course was uneventful, and he was discharged on postoperative day 12. Endocrine and exocrine function of the pancreas were maintained well at 10 months after surgery. PG is one of the useful choices for patients with PAP to prevent POPF while maintaining the pancreatic endocrine and exocrine function after PD.


Pancreas ◽  
2021 ◽  
Vol 50 (4) ◽  
pp. 639-644
Author(s):  
Munenori Tahara ◽  
Takuya Harada ◽  
Yosuke Wakui ◽  
Shoichiro Mizukami ◽  
Kengo Kita ◽  
...  

2009 ◽  
Vol 24 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Luís Augusto da Silveira ◽  
Fernando Braga Cassiano Silveira ◽  
Valéria Paula Sassoli Fazan

PURPOSE: Despite the fact that anatomical variations of the celiac trunk are well explored in the literature, information on these vessels diameters is scanty. The aims of the present study were to describe the arterial diameters of the celiac trunk and its main branches, and to investigate if these diameters are altered in those cases presenting anatomical variations of these vessels. METHODS: Twenty-one formalin fixed adult male cadavers were appropriately dissected for the celiac trunk identification and arterial diameter measurements. Arteries measured included the celiac trunk and its main branches (splenic artery, left gastric artery and common hepatic artery), as the proper hepatic artery, right gastric artery, the left and right hepatic arteries and the gastroduodenal artery. RESULTS: From the 21 cadavers, 6 presented anatomical variations of, at least, one of the above mentioned branches. The average arterial diameter comparisons between groups (normal and variable) clearly showed smaller diameters for variable vessels, but with no significant difference. CONCLUSION: Our data indicates the possibility of a diameter reduction of the celiac trunk main branches in the presence of anatomical variations. This should be taken into account on the selection for the liver transplantation donors.


2010 ◽  
Vol 32 (9) ◽  
pp. 883-885 ◽  
Author(s):  
Mo Jin Wang ◽  
Zhong Cheng ◽  
Rui Wang ◽  
Yuan Li ◽  
Zong Guang Zhou

2020 ◽  
Vol 24 (11) ◽  
pp. 2700-2701
Author(s):  
Omid Salehi ◽  
Eduardo A. Vega ◽  
Onur C. Kutlu ◽  
Sylvia V. Alarcon Velasco ◽  
Sandeep Krishnan ◽  
...  

2019 ◽  
Vol 27 (2) ◽  
pp. 13-18
Author(s):  
I. V. Gaiyvoronsky ◽  
P. M. Bykov ◽  
M. G. Gaivoronskaya ◽  
G. I. Sinenchenko

The rapid development of transplantation, endovascular and minimally invasive surgery necessitates a detailed study of the structural features of the vessels of the abdominal cavity. The purpose of the study is the characteristics of the morphometric parameters of the abdominal aorta and its unpaired branches in men and women at different ages and depending on the body type. The analysis of 266 computer tomograms of the abdominal part of aorta and its unpaired branches was carried out in adult men women divided into three age groups (first and second periods of mature age and elderly age), as well as into three groups according to the Pinier index (asthenic, normosthenic and hypersthenic body types). It was established that individual morphometric parameters of the abdominal part of aorta and its unpaired branches in men and women significantly change with age. It is proved that the diameter of the aorta at various levels significantly increases with age from the first mature to the elderly age by an average of 5 mm. However, in men, the length of the abdominal aorta, celiac trunk and main trunk of the superior mesenteric artery does not change with age. In women, the length of the celiac trunk increases with age at 5.9 mm, the length of the main trunk of the superior mesenteric artery - at 17 mm. The angle of discharge of the celiac trunk in men changes unevenly with age - in the second period of mature age, there is a statistically significant decrease by an average to 12.3°, then in old age an increase to 15°. Moreover, in women, the values of this indicator vary more evenly. The angles of discharge of other vessels did not show a clear age dependence, since this parameter is largely due to the constitutional features. The aorto-mesenteric distance changes with age only in women. In elderly age, it is on average 4.4 mm larger than in the first period of mature age. It was also found that there are significant differences between constitutional types identified using the Pinier index in the overwhelming majority of the morphometric parameters studied. The obtained information has a significant clinical importance, since it will allow objectifying the diagnostic criteria of various vascular syndromes and minimizing the risk of endovascular interventions.


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