Vladislav Brasoveanu1,2, Ion Barbu1, Florin Ichim1, Irina Balescu3, Nicolae Bacalbasa4,5,6. 1. "Dan Setlacec" Center of Gastrointestinal Diseases and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania. 2. "Titu Maiorescu" University of Medicine and Pharmacy, Bucharest, Romania. 3. "Ponderas" Academic Hospital, Bucharest, Romania irina.balescu@ponderas-ah.ro. 4. "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania. 5. Center of Excellence in Translational Medicine, Fundeni Clinical Institute, Bucharest, Romania. 6. "I. Cantacuzino" Clinical Hospital, Bucharest, Romania.
Abstract
BACKGROUND/AIM: Locally advanced pancreatic body tumors invading the celiac axis and the portal vein have been considered since long as unresectable lesions; however, due to improvement of surgical techniques, in certain cases surgery with curative intent might be taken in consideration. CASE REPORT: We present the case of a 48-year-old female investigated for epigastric pain that was diagnosed with a locally invasive pancreatic body tumor. The patient was submitted to computed tomography which revealed the presence of a locally advanced pancreatic tumor with no demarcation line with the celiac axis and the portal vein. The endoscopic ultrasound raised the suspicion of malignancy and retrieved a biopsy which demonstrated the presence of a pancreatic adenocarcinoma. The patient was submitted to surgery, distal pancreatectomy en bloc with splenectomy, celiac axis and portal vein resection was performed; the hepatic artery was reconstructed by placing a cadaveric graft while the portal vein was sutured per primam by an end to end anastomosis. The postoperative outcome was favorable, and the patient was discharged in the 10th postoperative day. CONCLUSION: Multiple vascular resections followed by reconstructions might be needed in order to achieve resection with negative margins in patients with pancreatic body tumors. Copyright
BACKGROUND/AIM: Locally advanced pancreatic body tumors invading the celiac axis and the portal vein have been considered since long as unresectable lesions; however, due to improvement of surgical techniques, in certain cases surgery with curative intent might be taken in consideration. CASE REPORT: We present the case of a 48-year-old female investigated for epigastric pain that was diagnosed with a locally invasive pancreatic body tumor. The patient was submitted to computed tomography which revealed the presence of a locally advanced pancreatic tumor with no demarcation line with the celiac axis and the portal vein. The endoscopic ultrasound raised the suspicion of malignancy and retrieved a biopsy which demonstrated the presence of a pancreatic adenocarcinoma. The patient was submitted to surgery, distal pancreatectomy en bloc with splenectomy, celiac axis and portal vein resection was performed; the hepatic artery was reconstructed by placing a cadaveric graft while the portal vein was sutured per primam by an end to end anastomosis. The postoperative outcome was favorable, and the patient was discharged in the 10th postoperative day. CONCLUSION: Multiple vascular resections followed by reconstructions might be needed in order to achieve resection with negative margins in patients with pancreatic body tumors. Copyright
Authors: T A Sohn; C J Yeo; J L Cameron; L Koniaris; S Kaushal; R A Abrams; P K Sauter; J Coleman; R H Hruban; K D Lillemoe Journal: J Gastrointest Surg Date: 2000 Nov-Dec Impact factor: 3.452
Authors: Nicolae Bacalbasa; Iulian Brezean; Claudiu Anghel; Ion Barbu; Mihai Pautov; Irina Balescu; Vladislav Brasoveanu Journal: In Vivo Date: 2017 Sep-Oct Impact factor: 2.155