Distal pancreatectomy with celiac axis resection (DP-CAR): Optimal perioperative outcome in a patient with locally advanced pancreas adenocarcinoma
| Autor: | Ilias Athanasiadis, Gregory G. Tsiotos, Panoraia Ziogou, Nikiforos Ballian, Fotios Milas |
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| Rok vydání: | 2020 |
| Předmět: |
NAC
neoadjuvant chemotherapy medicine.medical_specialty PV portal vein Borderline pancreatic cancer GDA gastroduodenal artery LFTs liver function tests Locally advanced pancreatic cancer medicine.medical_treatment Distal pancreatectomy Celiac axis Case Report CA celiac axis Resection Pancreatectomy SMV superior mesenteric vein medicine DP-CAR Hepatic artery resection EBL estimated blood loss Celiac axis resection business.industry SMA superior mesenteric artery CHA common hepatic artery Appleby operation Perioperative medicine.disease ICU intensive care unit CT computed tomography Surgery DP-CAR distal pancreatectomy with celiac axis resection PC pancreatic cancer medicine.anatomical_structure Adenocarcinoma PHA proper hepatic artery Pancreas business human activities |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Highlights • DP-CAR: A rare, technically demanding operation with significant morbidity & mortality. • DP-CAR may provide curative (R0) resection of an otherwise unresectable cancer. • Our patient had optimal perioperative outcome and excellent histology result. • To the best of our knowledge this is the first DP-CAR case in Greece. Introduction Distal pancreatectomy with en bloc celiac axis resection (DP-CAR) is an operation technically demanding, uncommonly performed, even in high-volume pancreatic centers, which may offer a curative resection in patients with locally advanced cancer of the body of the pancreas, otherwise considered unresectable. Presentation of case We present, in clinical and technical detail, a patient with DP-CAR with a very good intraoperative and postoperative course, no complications, short hospital stay, and histology consistent with a curative resection. Discussion Because of the scarcity of DP-CAR, even high-volume individual centers have been able to gather relatively limited experience, and only in a time frame of more than a decade each. Conclusion DP-CAR can be curative for a minority of patients with pancreatic adenocarcinoma and is performed only in centers with a long, dedicated interest in advanced pancreatic surgery with a well-known track record in resection of borderline and locally advanced pancreatic cancer involving major peripancreatic veins. |
| Databáze: | OpenAIRE |
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