Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas

A 64-year-old female patient with adenocarcinoma of the head of the pancreas with encasement of the common hepatic artery and portal vein stenosis was reexplored after six cycles of gemcitabine (1000 mg/m2). Prior to surgery, the patient underwent balloon dilation and stenting of the portal vein in...

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Bibliographic Details
Published in:Case Reports in Medicine Vol. 2013; no. 2013; pp. 113 - 116-027
Main Authors: Aerts, Raymond, Maleux, Geert, Schadde, Erik, Sergeant, Gregory
Format: Journal Article
Language:English
Published: Cairo, Egypt Hindawi Limiteds 01.01.2013
Hindawi Puplishing Corporation
Hindawi Publishing Corporation
John Wiley & Sons, Inc
Wiley
Subjects:
Adenocarcinoma
Care and treatment
Case Report
Case studies
Diagnosis
Health aspects
Pancreaticoduodenectomy
Patient outcomes
Belgium
Switzerland
ISSN:1687-9627, 1687-9635
Online Access:Get full text
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Summary:A 64-year-old female patient with adenocarcinoma of the head of the pancreas with encasement of the common hepatic artery and portal vein stenosis was reexplored after six cycles of gemcitabine (1000 mg/m2). Prior to surgery, the patient underwent balloon dilation and stenting of the portal vein in addition to successful coil embolisation of the common hepatic artery, proper hepatic artery, and proximal gastroduodenal artery. After embolisation, a pylorus-preserving pancreaticoduodenectomy was performed with resection of the common hepatic artery and portal vein confluens. Pathological examination showed a moderately differentiated pT3N0 (Stage IIa, TNM 7th edition) tumor with negative section margins. We show with this case that in selected cases of periampullary cancer with encasement of the common hepatic artery, it is technically feasible to perform pancreaticoduodenectomy with hepatic artery resection and negative surgical margins. Nevertheless, the oncological benefit of extended arterial resections remains controversial.
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Academic Editor: Thomas Vogl
ISSN:1687-9627
1687-9635
DOI:10.1155/2013/205475