[A Case of Gastric Cancer with Peripancreatic Aneurysm Treated with Embolization before Gastrectomy]

An 81-year-old man was admitted to our hospital with a 24-mm peripancreatic aneurysm and occlusion of the celiac artery on abdominal contrast-enhanced CT for preoperative screening of gastric cancer. Angiography showed severe stenosis at the origin of the celiac artery and an aneurysm in the anterior superior pancreaticoduodenal artery for which coil embolization was performed. The patient underwent laparoscopic distal gastrectomy on the 6th day post-embolization. Intraoperative ICG fluorescence confirmed good blood flow into the liver and residual stomach. The patient had a good postoperative course and was discharged on postoperative day 10. He has been recurrence-free for 10 months postoperative. Abdominal visceral aneurysms are at high risk of rupture and should be treated, but the presence of an aneurysm in the surgical site increases the risk further and requires treatment. A preoperative vascular evaluation and aneurysmal embolization in the abdominal region, as in this case, may help reduce intraoperative and postoperative risks.