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Case Reports in Medicine
Volume 2012, Article ID 543167, 5 pages
http://dx.doi.org/10.1155/2012/543167
Case Report

Extended Distal Pancreatectomy with En Bloc Resection of the Celiac Axis for Locally Advanced Pancreatic Cancer: A Case Report and Review of the Literature

1Department of General, Visceral and Transplantat Surgery, University Hospital of the RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany
2Department of Diagnostic and Interventional Radiology, University Hospital of the RWTH Aachen, Pauwelsstr 30, 52074 Aachen, Germany

Received 29 December 2011; Revised 23 January 2012; Accepted 24 January 2012

Academic Editor: Yasuhiko Sugawara

Copyright © 2012 Patrick H. Alizai et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Due to a lack of early symptoms, pancreatic cancers of the body and tail are discovered mostly at advanced stages. These locally advanced cancers often involve the celiac axis or the common hepatic artery and are therefore declared unresectable. The extended distal pancreatectomy with en bloc resection of the celiac artery may offer a chance of complete resection. We present the case of a 48-year-old female with pancreatic body cancer invading the celiac axis. The patient underwent laparoscopy to exclude hepatic and peritoneal metastasis. Subsequently, a selective embolization of the common hepatic artery was performed to enlarge arterial flow to the hepatobiliary system and the stomach via the pancreatoduodenal arcades from the superior mesenteric artery. Fifteen days after embolization, the extended distal pancreatectomy with splenectomy and en bloc resection of the celiac axis was carried out. The postoperative course was uneventful, and complete tumor resection was achieved. This case report and a review of the literature show the feasibility and safety of the extended distal pancreatectomy with en bloc resection of the celiac axis. A preoperative embolization of the celiac axis may avoid ischemia-related complications of the stomach or the liver.