A New Surgical Technique of Pancreaticoduodenectomy with Splenic Artery Resection for Ductal Adenocarcinoma of the Pancreatic Head and/or Body Invading Splenic Artery: Impact of the Balance between Surgical Radicality and QOL to Avoid Total Pancreatectomy
Indication of PD-SAR according to MDCT findings (a), intraoperative findings ((b) dotted circle indicates tumor border and schema of intraoperative findings) (c), and the arterial anatomy around the pancreas ((d) double line indicates cutting sites of artery). GB: gallbladder. CBD: common bile duct. SMV: superior mesenteric vein. SMA: superior mesenteric artery. SA: splenic artery. CeA: celiac artery. PHA: proper hepatic artery. LGA: left gastric artery. CHA: common hepatic artery. GDA: gastroduodenal artery. PSPDA: posterior superior pancreaticoduodenal artery. ASPDA: anterior superior pancreaticoduodenal artery. DPA: dorsal pancreatic artery. TPA: transverse pancreatic artery. SGA: short gastric artery. LGEA: left gastroepiploic artery. PEA: posterior epiploic artery.