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Pancreaticoduodenectomy Combined Gastroduodenal Collateral Reconstruction and Preservation Due to Median Arcuate Ligament Syndrome: Technical Notes with Two Surgical Cases Report (with Video) by Thanh Khiem Nguyen; Ham Hoi Nguyen; Tuan Hiep Luong; Pisey Chantha; Gia Khanh Ngo; Van Duy Le; Kim Khue Dang; Duc Huy Tran; Cuong Thinh Nguyen is a Medicine article available to read on EtoBox.
What is Pancreaticoduodenectomy Combined Gastroduodenal Collateral Reconstruction and Preservation Due to Median Arcuate Ligament Syndrome: Technical Notes with Two Surgical Cases Report (with Video) about?
## Introduction Pancreaticoduodenectomy in patients with CA stenosis due to median arcuate ligament often required carefully collateral pathways management to avoid hepatic ischemic complications. ## Cases presentation Case 1: A 63-year-old man was referred to our department because of jaundice with distal common bile duct tumor. Pancreaticoduodenectomy with left posterior SMA first approach and circumferential lymphadenectomy was performed. Case 2: A 48-year-old man was referred to our department because of right-upper-quadrant abdominal pain with Vater tumor. Laparoscopic pancreaticoduodenectomy with left posterior SMA first approach and circumferential lymphadenectomy was performed. Postoperatively, in all two cases, three-dimensional reconstruction images showed developed collateral pathways around the pancreatic head, and the CA was stenosis in 75% and 70% due to MAL, respectively. Intraoperatively, in all two cases, we confirmed poor blood flow in the common hepatic artery (CHA) by palpation and observation. So that in the first case, we have decided to proceed a no-touch technique of GDA segmental resection en bloc with the tumor and reconstructed with an end-to-end GDA anas
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- Author
- Thanh Khiem Nguyen; Ham Hoi Nguyen; Tuan Hiep Luong; Pisey Chantha; Gia Khanh Ngo; Van Duy Le; Kim Khue Dang; Duc Huy Tran; Cuong Thinh Nguyen
- Publisher
- Springer Science and Business Media LLC
- Published
- 2023
- Language
- EN
- Field
- Medicine (Health Sciences)