Pancreaticoduodenectomy for Carcinoma of the Papilla of Vater Associated with Celiac Occlusion -A Case Report and a Review of Literatures-

Fumio Chikamori, Naoto Gunji, Hiroyuki Aoyagi, Susumu Shibuya*, Yasuhiro Takase*, Katashi Fukao*

Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital
*Department of Surgery, Institute of Clinical Medicine, University of Tsukuba

A 56-year-old woman with coexistent carcinoma of the papilla of Vater, celiac occlusion and pancreaticoduodenal artery aneurysm underwent pancreaticoduodenectomy. Preoperative angiography showed that the arterial blood supply to the celiac viscera was sustained by the superior mesenteric artery via the right hepatic artery- an uncommon branch through the pancreaticoduodenal artery (PDA). An end-to-end anastomosis of the gastroduodenal artery (GDA) and posterior inferior PDA was constructed using 6-0 polypropylene. The postoperative course was uneventful. Patency of the anastomosis was confirmed angiographically on the 35th postoperative day. Therefore, we think that anastomosis of the GDA and posterior inferior PDA is a useful method in such cases.

Key words
pancreaticoduodenectomy, celiac occlusion, pancreaticoduodenal artery aneurysm

Reprint requests
Fumio Chikamori Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital
1-3-1 Amakubo, Tsukuba, 305 JAPAN

Accepted
January 13, 1993

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