ArticleInternational journal of surgery case reports2022
Pancreatoduodenectomy in a patient with celiac axis stenosis and a replaced common hepatic artery: A case report.
Article in International journal of surgery case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 4 citations in OpenAlex.
- Rare arterial variations associated with dorsal pancreatic agenesis.Anatomy & cell biology · 2026Article
- Sequential Flow-Based Assessment of a Suspected Inferior Pancreaticoduodenal Artery-Derived Pathway Entering the Right Hepatic Artery during Pancreaticoduodenectomy: A Case Report.Surgical case reports · 2026Article
- A rare case of coeliac-colica-mesenteric anastomosis: distal anastomosis between the coeliac trunk and the left colic artery.Surgical and radiologic anatomy : SRA · 2025Article
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5 authors at 1 institution in 1 country.
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Abstract
introductionEvaluation 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.
conclusionPrecise preoperative diagnosis of arterial anomalies is necessary to avoid postoperative complications that may be induced by intraoperative arterial injury and organ ischemia.
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