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
Intraoperative findings after PD-SAR (a) and schemas of reconstruction after PD-SAR and postoperative MDCT showing clear enhancement of the remnant pancreas (b)–(e). (b) and (c): schema of reconstruction after subtotal stomach preserving PD-SAR and postoperative MDCT. (d) and (e): schema of reconstruction after PD-SAR with total gastrectomy and splenectomy and postoperative MDCT. PV: portal vein. SMA: superior mesenteric artery. SA: splenic artery. CHA: common hepatic artery. GDA: gastroduodenal artery. SV: splenic vein. Rem P: remnant pancreatic parenchyma. SP: spleen.