A Case of Curatively Resected Locally Advanced Pancreatic Cancer Treated by Total Pancreatectomy with Celiac Axis Resection without Arterial Reconstruction Due to Preservation of the Aberrant Arteries

Abstract

A 68-year-old woman was referred to our hospital for evaluation of abdominal pain. CT images revealed a 40-mm mass in the body and head of the pancreas, and a diagnosis of unresectable pancreatic cancer was made due to involvement of the portal vein (PV) and splenic vein and abutting to the celiac artery, common hepatic artery and splenic artery at >180°. After 6 cycles of chemotherapy, CT showed a partial response and tumor markers normalized; thus, total pancreatectomy with celiac axis resection (TP-CAR) with PV resection was planned as a conversion surgery. TP-CAR basically requires arterial reconstruction for hepatic flow. However, planned TP-CAR without arterial reconstruction was performed due to preservation of the aberrant arteries. Pathological findings revealed R0 resection, and there was no recurrence at 16 months follow-up. We report here a successful case of TP-CAR without arterial reconstruction due to preservation of the aberrant arteries.