Pancreatoduodenectomy with portal vein resection for pancreatic body cancer in a patient with situs inversus totalis |
| |
| Institution: | 1. Division of Hepatobiliary Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine Kyoto University, Kyoto, Japan;2. Department of Surgery, Kobe City Nishi-Kobe Medical Center, Kobe, Japan;1. Department of Medical Oncology, Medipol University, Medipol Bahçelievler Hospital, 34384, Istanbul, Turkey;2. Department of Nuclear Medicine, Yuzuncu Yil University Medical School, 65030, Van, Turkey;3. Department of Medical Oncology, Van Research and Training Hospital, Van, Turkey;4. Department of Medical Oncology, Yuzuncu Yil University Medical School, 65030, Van, Turkey;5. Department of General Surgery, Yuzuncu Yil University Medical School, Van, Turkey;1. Department of Thoracic Surgery, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa Ube, Yamaguchi, 755-0241, Japan;2. Clinical Research, National Hospital Organization Yamaguchi Ube Medical Center, 685 Higashikiwa Ube, Yamaguchi, 755-0241, Japan;3. Department of Pathology, KYURIN/ KYURIN PACELL Corporation, 26-67 Morishita-cho, Yahatanishi-ku, Kitakyushu, Fukuoka, 806-0046, Japan;4. Department of Pathology, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan;1. University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Cardiothoracic Surgery, Kerpener Strasse 62, 50937, Cologne, Germany;2. University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Pathology, Kerpener Strasse 62, 50937, Cologne, Germany;3. University of Cologne, Faculty of Medicine, Joseph-Stelzmann-Strasse 20, 50931, Köln, Germany |
| |
| Abstract: | BackgroundSitus inversus totalis (SIT) is a rare congenital condition characterized by complete transposition (right-to-left reversal) of the thoracic and abdominal organs. The estimated prevalence of SIT is 1 per 8000–25,000 live births 1]. Surgery for abdominal diseases in patients with SIT is technically demanding because of anatomical variations 2], 3], 4]]; the importance of preoperative radiological assessment has been reported 4]. We report a case of SIT with complex vascular anomalies and pancreatic body cancer who underwent pancreatoduodenectomy with combined resection of the portal vein.MethodsA 79-year-old man with asymptomatic SIT was referred to our hospital for the treatment of pancreatic cancer that was incidentally found during a medical check-up. Abdominal computed tomography (CT) revealed a hypovascular tumor in the pancreatic body with a diameter of 32 mm involving the portal vein. He did not have SIT-associated diseases such as Kartagener syndrome or other malformations but had complex anomalies of vascular anatomy, especially in the hepatic arterial system, in addition to mirror-image transposition.ResultsThe operation was performed successfully with a full understanding of the vascular anatomy based on precise preoperative evaluation of CT images, including three-dimensional reconstruction images. The operative time was 710 min, and blood loss was 1237 mL. The Union for International Cancer Control (UICC) pathological stage was Stage III (T2, N2, M0).ConclusionPancreatoduodenectomy with portal vein resection for pancreatic cancer in patients with SIT is a complex procedure. Precise preoperative assessment of CT images with three-dimensional reconstruction is crucial to understanding vascular anatomy and safely performing surgery. |
| |
| Keywords: | Situs inversus totalis Pancreatic cancer Pancreatoduodenectomy |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
