Related Experiment Video
Updated: Aug 6, 2026
Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique
Published on: August 14, 2021
Extended pancreatectomy with resection of the celiac axis: the modified Appleby operation
Singh Gagandeep1, Avo Artinyan, Nicolas Jabbour
1Division of Hepatobiliary/Pancreatic Surgery and Transplant Surgery, University of Southern California University Hospital, 1510 San Pablo St., HCC1 Suite 200, Los Angeles, CA 90033, USA.
Background:
Celiac axis invasion by central and distal pancreatic cancers has been considered a contraindication to resection. Appleby first described en-bloc celiac axis resection with total gastrectomy for locally advanced gastric cancer. We present our experience with a modification of this procedure in central pancreatic cancers involving the celiac trunk.
Methods:
Three patients with central pancreatic cancers invading the celiac axis are reviewed. All patients underwent extended pancreatectomy with en-bloc resection of the celiac axis.
Results:
Margins were grossly clear of tumor in all patients. The mean length of stay was 8.3+/-1.1 days. There was no evidence of clinically significant gastric or hepatic ischemia. All 3 patients remain disease free at 34, 14, and 14 months from surgery, respectively.
Comments:
Extended pancreatectomy with celiac axis resection can result in prolonged survival and should be considered in central and distal pancreatic cancers invading the celiac trunk.
