PMC5994732_01
Angiogram from the celiac axis shows pseudoaneurysm at left gastric artery and active extravasation at gastroduodenal artery stump. The common hepatic artery proper can not be identified.
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A coil embolization was done in the GDA and the common hepatic artery as shown in Fig. 1.
Angiogram from celiac axis after coil embolization and portal vein arterialization was carried out.
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Unfortunately, the right hepatic artery and common hepatic artery were extensively thrombosed so, portal vein arterialization was done by connection of the common hepatic artery to the splenic vein in end-to-side fashion using the polypropylene 6/0 running technique as shown in Fig. 2.
Fig. 3 shows AST and ALT level related to total hepatic de-arterialization and portal vein arterialization.
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During the early postoperative period liver function improved gradually as shown in Fig. 3.