A Case of Hepatomesenteric-type Variation of Hepatic Arterial Blood Flow Treated by Pylorus-preserving Pancreatodoudenectomy

Takashi Hara¹⁾²⁾, Masaaki Nenohi¹⁾, Yuuji Sasamura¹⁾, Satoshi Takeyama¹⁾, Akihiko Numata¹⁾, Satoshi Kondo²⁾ and Hiroyuki Katoh²⁾

Department of Surgery, Asahikawa City Hospital¹⁾
Department of Surgical Oncology, Hokkaido University School of Medicine²⁾

A 69-year-old man preoperatively diagnosed with non invasive intraductal papillary-mucious tumor of the pancreatic head had a common hepatic artery (CHA) and superior mesenteric artery stemming commonly, with hepatomesenteric hepatic arterial blood flow. We conducted pylorus-preserving pancreatoduodenectomy involving resecting of CHA. As the intraoperative total blood flow of the right and the left hepatic arteries measured over 100 ml/min after resection of the proper hepatic artery, the blood flow was not reconstructed. No postoperative complications occurred. Pathological diagnosis was non invasive tumor with neither lymph node metastasis nor invasion of the vasculature. Special attention must be given in surgery on the pancreatic head in a patient with a variation of hepatic arterial blood flow. Particularly in a patient with a hepatomesenteric variation, the condition must be evaluated accurately.

Key words
ntraductal papillary-mucious tumor, hepatomesenteric type, pylorus-preserving pancreatoduodenectomy

Reprint requests
Takashi Hara Department of Surgical Oncology, Hokkaido University School of Medicine
Kita 15-jo, Nishi 7-chome Kita-ku, Sapporo, 060-8638 JAPAN

Accepted
November 30, 2004

To read the PDF file you will need Abobe Reader installed on your computer.