A Case of Pancreas Head Carcinoma Associated with Stenosis of the Celiac Axis -The Significance of Intraoperative Evaluation of the Hepatic Artery-

Mitsuru Dohke, Hiroyuki Kato, Toshiji Motohara, Syunichi Okushiba, Toshiyuki Takahashi

Second Department of Surgery, Hokkaido University School of Medicine

We report a case of pancreas head carcinoma associated with stenosis of the celiac axis (SCA). Pancreatoduodenectomy was safely performed while evaluating hepatic arterial flow by electromagnetic flowmetry. The patient is a 52-year-old man, and his angiogram showed the arcade of the pancreas head was remarkably dilated, and the hepatic and splenic arteries were imaged through the inferior pancreatoduodenal and gastroduodenal arteries. The lateral view of the aortogram revealed compression in the celiac axis. He was diagnosed as having pancreas head carcinoma with SCA. the intraoperative left hepatic arterial flow was 20 ml/sec ordinary, 20 ml/sec under clamping of the gastroduodenal artery, and 26 ml/sec after cutting of the gastroduodenal artery and the median arcuate ligament. During surgery for pancreas head tumors with SCA, it is essential for preventing postoperative complications to measure the hepatic arterial flow.

Key words
celiac axis compression syndrome, electromagnetic flowmetry, pancreatoduodenectomy

Reprint requests
Mitsuru Dohke Second Department of Surgery, Hokkaido University School of Medicine
Kita-l5, Nishi-7, Kita-ku, Sapporo, 060 JAPAN

Accepted
November 15, 1995

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