Open AccessLiver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy
Author(s) -
В И Егоров,
Roman Petrov,
M.V. Lozhkin,
O. A. Maynovskaya,
Natalia Starostina,
Natalia Chernaya,
Е. М. Филиппова
Publication year - 2013
Publication title -
world journal of gastrointestinal surgery
Language(s) - English
Resource type - Journals
ISSN - 1948-9366
DOI - 10.4240/wjgs.v5.i3.51
Subject(s) - medicine , blood supply , angiography , multidetector computed tomography , radiology , computed tomography , pancreatic ductal adenocarcinoma , blood loss , pancreatic cancer , surgery , cancer
Reported here are two cases of a modified Appleby operation for borderline resectable ductal adenocarcinoma of the pancreatic body, in one of which a R0 distal resection was attended to by excision, not only of the celiac axis, but also of the common and left hepatic arteries in the presence of arterial anatomic variation Michels, type VIIIb. The possibility and avenues of the maintenance of the blood supply to the left hepatic lobe after surgical aggression of this kind are demonstrated employing computed tomography (CT) and 3-D CT angiography. Furthermore, both cases highlight all important worrisome aspects of pancreatic cancer resectability prediction.