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Updated: Jun 30, 2026
Robot Assisted Distal Pancreatectomy with Celiac Axis Resection (DP-CAR) for Pancreatic Cancer: Surgical Planning and Technique
Published on: August 14, 2021
Analysis of Hepatic Artery Reconstruction in Advanced Pancreatic Head Cancer
Atsumori Hamahata1, Toshiro Ogura2, Ibuki Fujinuma2
1From the Department of Plastic and Reconstructive Surgery, Saitama Cancer Center, Kita-Adachi-gun, Saitama, Japan.
Background:
Hepatic artery (HA) reconstruction is occasionally required in pancreatic head cancer with arterial involvement. With recent advances in combination chemotherapy, conversion surgery has become feasible for selected patients. This study evaluates the surgical techniques, postoperative outcomes, and survival of patients who underwent pancreatic resection with HA reconstruction.
Methods:
A retrospective review was conducted of 14 patients who underwent pancreatic resection with HA reconstruction at Saitama Cancer Center from 2012 to 2024. Clinical variables included demographics, tumor pathology, patterns of arterial invasion, reconstruction methods, anastomosis time, and complications. Patients were classified into 2 groups: those with common/proper HA invasion and those with replaced right HA invasion.
Results:
The cohort included 9 men and 5 women (mean age, 71.9 y). Six patients had common/proper HA invasion, and 8 had replaced right HA invasion. The overall median anastomosis time was 18 minutes 16 seconds. No anastomosis-related complications occurred, and hepatic arterial flow was patent in all patients.
Conclusions:
Meticulous microsurgical HA reconstruction enables safe arterial resection in selected patients with advanced pancreatic cancer. When combined with appropriate preoperative therapy and multidisciplinary management, this approach allows oncologically curative resection and may contribute to improved long-term survival.
