Brasoveanu Vladislav, Romanescu Dragos, Diaconu Camelia, Iliescu Laura, Stiru Ovidiu, Brezean Iulian, Belu Emil, Savu Carmen, Savu Cornel, Bratu Ovidiu, Gorecki Gabriel, Pop Lucian, Balescu Irina, Bacalbasa Nicolae
Department of Surgery, 'Dan Setlacec' Center of Gastrointestinal Diseases and Liver Transplantation, 'Fundeni' Clinical Institute, 022328 Bucharest, Romania.
Department of Surgery, 'Sanador' Medical Center, 011038 Bucharest, Romania.
Exp Ther Med. 2021 Jan;21(1):87. doi: 10.3892/etm.2020.9518. Epub 2020 Nov 26.
Pancreatic head cancer is frequently associated with invasion of the surrounding vascular structures, such cases being considered for a long period of time as unresectable. Improvement of the vascular surgery techniques allowed association of extended vascular resections and reconstructions, increasing in this way the percentage of patients benefiting from radical surgery. We present the case of a 47-year-old male patient with no significant medical history diagnosed with a large pancreatic head tumor invading the common and proper hepatic artery as well as the portal vein. The venous reconstruction was performed using a synthetic prosthesis while the left hepatic artery was sutured to the left gastric artery; meanwhile the right hepatic artery was reconstructed using the splenic artery. In conclusion, extended hepatic artery resection followed by arterial reconstruction in association with portal vein resection and prosthetic replacement might be needed in cases presenting large pancreatic head tumors with vascular invasion.
胰头癌常伴有周围血管结构受侵，长期以来这类病例被视为不可切除。血管外科技术的改进使得扩大性血管切除和重建得以联合应用，从而提高了受益于根治性手术的患者比例。我们报告一例47岁男性患者，无重大病史，诊断为巨大胰头肿瘤，侵犯肝总动脉、肝固有动脉及门静脉。静脉重建采用人工血管，左肝动脉与胃左动脉缝合；同时，利用脾动脉重建右肝动脉。总之，对于出现伴有血管侵犯的巨大胰头肿瘤的病例，可能需要进行扩大性肝动脉切除并联合动脉重建以及门静脉切除和人工血管置换。
