Liver blood supply after a modified Appleby procedure in classical and aberrant arterial anatomy  

作　　者：Vyacheslav I Egorov Roman V Petrov Michail V Lozhkin Olga A Maynovskaya Natalia S Starostina Natalia R Chernaya Ekaterina M Filippova 

机构地区：[1]Ostroumov 14~(th) City Hospital, Department of Surgical Oncology, Sechenov First State Medical University [2]Department of General Surgery, Russian National Research Medical University [3]Department of Abdominal Surgery, Herzen Institute of Oncology [4]Department of Pathology, Herzen Institute of Oncology [5]Department of Radiological, Herzen Institute of Oncology [6]Department of Interventional Radiology,Sklifosovsky Emergency Institute [7]Department of Pathology, Vishnevsky,Institute of Surgery

出　　处：《World Journal of Gastrointestinal Surgery》2013年第3期51-61,共11页世界胃肠外科杂志（英文版）（电子版）

摘　　要：Reported here are two cases of a modified Appleby operation for borderline resectable ductal adenocarcinoma of the pancreatic body, in one of which a R0 distal resection was attended to by excision, not only of the celiac axis, but also of the common and left hepatic arteries in the presence of arterial anatomic variation Michels, type Ⅷb. The possibility and avenues of the maintenance of the blood supply to the left hepatic lobe after surgical aggression of this kind are demonstrated employing computed tomography (CT) and 3-D CT angiography. Furthermore, both cases highlight all important worrisome aspects of pancreatic cancer resectability prediction.Reported here are two cases of a modified Appleby operation for borderline resectable ductal adenocarcinoma of the pancreatic body, in one of which a R0 distal resection was attended to by excision, not only of the celiac axis, but also of the common and left hepatic arteries in the presence of arterial anatomic variation Michels, type Ⅷb. The possibility and avenues of the maintenance of the blood supply to the left hepatic lobe after surgical aggression of this kind are demonstrated employing computed tomography (CT) and 3-D CT angiography. Furthermore, both cases highlight all important worrisome aspects of pancreatic cancer resectability prediction.

关 键 词：Cancer PANCREAS Management PANCREATECTOMY DISTAL PANCREATECTOMY Vascular invasion COMPUTED tomography Blood supply 

分 类 号：R322[医药卫生—人体解剖和组织胚胎学]