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
The arterial supply of the remnant pancreas after PD-SAR. MDCT (a) and 3D CT angiography (b) after subtotal stomach preserving PD-SAR showing SA clearly enhanced from SGAs anastomosing with LGA. Pre- (c) and postoperative MDCTs (d) in PD-SAR with total gastrectomy and splenectomy: SA and Rem P are enhanced even after PD-SAR with total gastrectomy and splenectomy, probably from PEA. LGA: left gastric artery. SGA: short gastric artery. SMA: superior mesenteric artery. SA: splenic artery. SP: spleen. Rem P: remnant pancreas. PEA: posterior epiploic artery.