Pancreatoduodenectomy for periampullary cancer associated with celiac occlusion: a case report

A 62-year-old man with atherosclerotic occlusion of the celiac axis underwent pancreatoduodenectomy because of cancer of the common bile duct. Preoperative angiography showed that the arterial blood supply to the celiac viscera was sustained through the gastroduodenal artery via the pancreaticoduodenal arcades from the superior mesenteric artery. Therefore reconstruction of the celiac circulation was attempted before division of the gastroduodenal artery. An autograft of the saphenous vein was placed between the infrarenal aorta and the common hepatic artery. The postoperative course was uneventful. Patency of the graft was demonstrated angiographically on the 50th postoperative day.