PMC7653469_01
Preoperative computed tomography (Case #1) showed that.. a: a hypodense lesion in the pancreatic body (black head) and dilation of the distal pancreatic duct (white head).. b: the SMA free from the tumor (white arrow).. c: the presence of the replaced RHA (white arrow).
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The tumor infiltrated the celiac artery (CA) without involvement of GDA (Fig. 1a, b). CT also confirmed the presence of r-RHA (Fig. 1c).
Operative findings and procedure.. The tumor was found to involve the root of the GDA and the PHA. After confirming complementary arterial flow to the left hemiliver from the replaced RHA through the hepatic hilum, the PHA and the GDA were ligated.
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Finally, we cut the left gastric artery (LGA) and CA, and finished Ex- DP-CAR (Fig. 2).
Postoperative transaminases.. The postoperative course was uneventful with no evidence of ischemic complications.
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The postoperative course was uneventful, with no ischemic complications, and the patient was discharged 10 days after the surgery (Fig. 3).