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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Main Authors: Gregory Sergeant, Erik Schadde, Geert Maleux, Raymond Aerts
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2013/205475
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author Gregory Sergeant
Erik Schadde
Geert Maleux
Raymond Aerts
author_facet Gregory Sergeant
Erik Schadde
Geert Maleux
Raymond Aerts
author_sort Gregory Sergeant
collection DOAJ
description 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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spelling doaj-art-d17edb16fcdb43a7a62966093bd9d18e2025-08-20T03:23:59ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/205475205475Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the PancreasGregory Sergeant0Erik Schadde1Geert Maleux2Raymond Aerts3Department of Abdominal Surgery, University Hospital Leuven, Herestraat 49, 3000 Leuven, BelgiumSwiss HPB Center, Department for Visceral and Transplantation Surgery, University Hospital Zurich, 8091 Zurich, SwitzerlandDepartment of Radiology, University Hospital Leuven, Herestraat 49, 3000 Leuven, BelgiumDepartment of Abdominal Surgery, University Hospital Leuven, Herestraat 49, 3000 Leuven, BelgiumA 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.http://dx.doi.org/10.1155/2013/205475
spellingShingle Gregory Sergeant
Erik Schadde
Geert Maleux
Raymond Aerts
Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas
Case Reports in Medicine
title Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas
title_full Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas
title_fullStr Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas
title_full_unstemmed Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas
title_short Hepatic Artery Embolization prior to En Bloc Resection of an Encased Common Hepatic Artery in Adenocarcinoma of the Head of the Pancreas
title_sort hepatic artery embolization prior to en bloc resection of an encased common hepatic artery in adenocarcinoma of the head of the pancreas
url http://dx.doi.org/10.1155/2013/205475
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AT geertmaleux hepaticarteryembolizationpriortoenblocresectionofanencasedcommonhepaticarteryinadenocarcinomaoftheheadofthepancreas
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