Distal pancreatectomy with en bloc resection of the celiac axis for pancreatic adenocarcinoma.
Clin Ter
; 160(4): 287-90, 2009.
Article
em En
| MEDLINE
| ID: mdl-19795078
ABSTRACT
Resection of celiac axis for gastric cancer was first performed by Appleby in 1953. Subsequently, Mayumi et al. and Kimura et al. adopted this approach for locally advanced adenocarcinoma of pancreatic body. We are here describing this technique in case of adenocarcinoma of pancreatic body with infiltration of celiac axis achieving also gastric preservation. Our patient presented with diabetes, back pain and weight loss. CT scan showed a 3 cm mass in the body of pancreas infiltrating the origin of celiac axis, causing obstructive atrophy of pancreatic tail. Bilirubin, transaminases, amylase and tumoral markers were in the normal range with the exception of CEA (34 ng/ml) and chromogranin (30 IU/l). Vascular reconstruction imaging indicated the feasibility of the procedure. Under intraoperative ultrasound guidance we clamped the common hepatic artery in order to check the gastric and hepatic blood flow. We then performed a distal pancreasectomy and splenectomy with "en bloc" resection of celiac axis and regional lymphadenectomy. Appleby operation can increase the resectability of locally advanced cancer of the body and tail of the pancreas and offers not only a better life quality for patients but also perfect pain relief. This technique demands a multidisciplinary approach with careful pre and intra operative vascular evaluation, which is mandatory in assessing candidacy for this procedure.
Buscar no Google
Bases de dados:
MEDLINE
Assunto principal:
Pancreatectomia
/
Neoplasias Pancreáticas
/
Adenocarcinoma
Limite:
Aged
/
Humans
/
Male
Idioma:
En
Revista:
Clin Ter
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Itália