Distal pancreatectomy with resection of the celiac axis and reconstruction of the hepatic artery for carcinoma of the body and tail of the pancreas

  • Masaru Konishi
  • Taira Kinoshita
  • Toshio Nakagori
  • Kazuto Inoue
  • Tatsuya Oda
  • Takahiro Kimata
  • Hiroyuki Kikuchi
  • Munemasa Ryu
Surgeon at work

Abstract:

Distal pancreatectomy with resection of the celiac axis can increase resectability of carcinoma of the body and tail of the pancreas. We performed reconstruction of the hepatic artery to avoid complications caused by a decrease in hepatic arterial flow. We carried out distal pancreatectomy with resection of the celiac axis for carcinoma of the body and tail of the pancreas in four patients. When pulsation in the proper hepatic artery was weak after occlusion of the celiac axis, we performed reconstruction of the hepatic artery, using the splenic artery, which had been taken beforehand from the resected specimen. In two patients, we performed reconstruction of the hepatic artery. These two patients underwent reconstruction of the portal vein combined with prolonged clamping of the portal vein. Levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated just after the operation, but recovered to normal levels within 10 days. No complications related to hepatic ischemia were observed. These results suggested that reconstruction of the hepatic artery allowed us to safely perform distal pancreatectomy with resection of the celiac axis for carcinoma of the body and tail of the pancreas.

Key words: pancreatic carcinoma, distal pancreatectomy, resection of the celiac axis, reconstruction of artery 

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Copyright information

© Springer-Verlag Tokyo 2000

Authors and Affiliations

  • Masaru Konishi
    • 1
  • Taira Kinoshita
    • 1
  • Toshio Nakagori
    • 1
  • Kazuto Inoue
    • 1
  • Tatsuya Oda
    • 1
  • Takahiro Kimata
    • 2
  • Hiroyuki Kikuchi
    • 3
  • Munemasa Ryu
    • 4
  1. 1. Department of Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa 277-8577, JapanJP
  2. 2. Department of Plastic Surgery, National Cancer Center Hospital East, Kashiwa, JapanJP
  3. 3. Department of Surgery, Shimotsuga Hospital, 5-32 Fujimicho, Tochigi 328-8505, JapanJP
  4. 4. Sawara Prefectual Hospital, 2285 Sawara, Sawara 287-0003, JapanJP

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