A case report of pancreaticoduodenectomy with en bloc celiac axis resection

To summarize the clinical experience of a case report of pancreaticoduodenectomy (PD) with en bloc celiac axis (CA) resection for locally advanced pancreatic cancer.

We retrospectively analyzed the clinical data of a patient with locally advanced pancreatic cancer who underwent PD with en bloc CA resection after neoadjuvant chemotherapy and embolization of the proper hepatic artery at the Department of Hepatopancreatobiliary Surgery of the First Affiliated Hospital of Ningbo University in May 2023. This study was approved by the ethics committee of the Ningbo First Hospital.

This case was operated on smoothly with an operative time of 535 minutes and intraoperative bleeding of approximately 800 mL. Only short-term elevation of hepatic aminotransferase appeared in the postoperative period, which was improved by hepatoprotective and symptomatic treatments. The patient was discharged from the hospital 20 days postoperatively, and no tumor recurrence occurred in the follow-up period.

In patients with locally advanced pancreatic cancer with simultaneous invasion of the celiac trunk, common hepatic artery, and hepatic innominate artery, total PD with en bloc CA resection is safe and feasible in cases where neoadjuvant chemotherapy is effective and after establishing hepatic collateral circulation by preoperative embolization of the hepatic innominate artery. Meanwhile, more cases from more centers are needed to validate this conclusion.