Hepatic artery reconstruction after extended resection for borderline resectable pancreatic head cancer: A case report

Brasoveanu,Vladislav; Romanescu,Dragos; Diaconu,Camelia; Iliescu,Laura; Stiru,Ovidiu; Brezean,Iulian; Belu,Emil; Savu,Carmen; Savu,Cornel; Bratu,Ovidiu; Gorecki,Gabriel; Pop,Lucian; Balescu,Irina; Bacalbasa,Nicolae

doi:10.3892/etm.2020.9518

Hepatic artery reconstruction after extended resection for borderline resectable pancreatic head cancer: A case report

Authors:
- Vladislav Brasoveanu
- Dragos Romanescu
- Camelia Diaconu
- Laura Iliescu
- Ovidiu Stiru
- Iulian Brezean
- Emil Belu
- Carmen Savu
- Cornel Savu
- Ovidiu Bratu
- Gabriel Gorecki
- Lucian Pop
- Irina Balescu
- Nicolae Bacalbasa
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Affiliations: Department of Surgery, ‘Dan Setlacec’ Center of Gastrointestinal Diseases and Liver Transplantation, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania, Department of Surgery, ‘Sanador’ Medical Center, 011038 Bucharest, Romania, Department of Internal Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Cardiovascular Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Oncology, ‘Prof. Dr. Al. Trestioreanu’ Institute of Oncology, 022328 Bucharest, Romania, Department of Anesthesiology, ‘Fundeni’ Clinical Institute, 022328 Bucharest, Romania, Department of Thoracic Surgery, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Urology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania, Department of Anaesthesia and Intensive Care, ‘Ilfov’ County Emergency Hospital, 022104 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Alessandrescu‑Rusescu’ National Institute of Mother and Child Health, Fetal Medicine Excellence Research Center, 020395 Bucharest, Romania, Department of Surgery, ‘Ponderas’ Academic Hospital, 021188 Bucharest, Romania, Department of Obstetrics and Gynecology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
Published online on: November 26, 2020 https://doi.org/10.3892/etm.2020.9518
Article Number: 87

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Abstract

Pancreatic head cancer is frequently associated with invasion of the surrounding vascular structures, such cases being considered for a long period of time as unresectable. Improvement of the vascular surgery techniques allowed association of extended vascular resections and reconstructions, increasing in this way the percentage of patients benefiting from radical surgery. We present the case of a 47‑year‑old male patient with no significant medical history diagnosed with a large pancreatic head tumor invading the common and proper hepatic artery as well as the portal vein. The venous reconstruction was performed using a synthetic prosthesis while the left hepatic artery was sutured to the left gastric artery; meanwhile the right hepatic artery was reconstructed using the splenic artery. In conclusion, extended hepatic artery resection followed by arterial reconstruction in association with portal vein resection and prosthetic replacement might be needed in cases presenting large pancreatic head tumors with vascular invasion.

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