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Pancreaticoduodenectomy with Hepatic Artery Resection

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The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases

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Abstract

With the development of novel and effective multidrug chemotherapy, several pancreatic centers have reported that the combination of preoperative chemotherapy and arterial resection can provide a favorable long-term prognosis for T4-stage (i.e., major artery infiltration) pancreatic cancer (PC) patients. A recent nomogram formulated to predict the post-resection prognosis of PC found that neoadjuvant treatment was an independent prognostic factor, whereas T4 stage was not a factor of poor prognosis. This implies that systemic control is the most important factor for improving the prognosis of PC and local progression has less impact on the prognosis in the era of useful multidrug regimens. However, even if favorable control of PC is achieved with neoadjuvant chemotherapy, pancreatectomy with hepatic artery (HA) resection is technically challenging. This approach requires a high expertise that is characterized with detailed preoperative image preparation, planning several options of HA reconstruction, meticulous intraoperative resection, and appropriate postoperative management. This chapter examines the innovative surgical approach and management in the pancreaticoduodenectomy with HA resection and reconstruction.

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Declaration of Interests

Dr. Del Chiaro has received grants from Haemonetics, Inc., and is the principal investigator of the study sponsored by Boston Scientific, which is not directly associated with the submitted work. The remaining authors have declared no competing interests.

Author information

Authors and Affiliations

  1. Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Atsushi Oba, Tomotaka Kato, Yosuke Inoue & Yu Takahashi

  2. Division of Surgical Oncology, Department of Surgery, University of Colorado, Anschutz Medical Campus, Denver, CO, USA

    Atsushi Oba, Marco Del Chiaro & Y. H. Andrew Wu

Authors
  1. Atsushi Oba
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  2. Tomotaka Kato
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  3. Marco Del Chiaro
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  4. Y. H. Andrew Wu
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  5. Yosuke Inoue
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  6. Yu Takahashi
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Corresponding author

Correspondence to Atsushi Oba .

Editor information

Editors and Affiliations

  1. Emeritus Professor, The University of Tokyo, Tokyo, Japan

    Masatoshi Makuuchi

  2. National Center for Global Health and Medicine, The University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

  3. “Dan Setlacec” Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania

    Irinel Popescu

  4. Emeritus Professor University Paris Cité, Paris, France

    Jacques Belghiti

  5. Department of Surgery, Seoul National University College of Medicine Seoul National University Bundang Hospital, Seoul, Korea (Republic of)

    Ho-Seong Han

  6. Nagahama City Hospital Network, Shiga, Japan

    Kyoichi Takaori

  7. Massachusetts General Hospital, Harvard Medical School, Boston, USA

    Dan G. Duda

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© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

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Oba, A., Kato, T., Del Chiaro, M., Wu, Y.H.A., Inoue, Y., Takahashi, Y. (2022). Pancreaticoduodenectomy with Hepatic Artery Resection. In: Makuuchi, M., et al. The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-19-0063-1_40

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  • DOI: https://doi.org/10.1007/978-981-19-0063-1_40

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-19-0062-4

  • Online ISBN: 978-981-19-0063-1

  • eBook Packages: MedicineMedicine (R0)

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