総肝動脈走行変異のある十二指腸乳頭部癌に対して幽門輪温存膵頭十二指腸切除術を施行した1例

菱田 光洋; 河合 庸仁; 阪井 満; 奥村 徳夫; 吉田 滋; 仲田 和彦; 森 良雄

doi:10.3919/jjsa.68.2877

Abstract

A 79-year-old man treated for hypertension was found to have jaundice. As a result of close examinations, he was diagnosed as having the tumor of ampulla of Vater or lower bile duct. 3D CT angiography showed the aberrant common hepatic artery which ascended on the anterior surface of the pancreas and continued as a normally positioned proper hepatic artery. Also, the gastroduodenal artery was absent. We performed a pylorus preserving pancreatoduodenectomy while carefully preserving this common hepatic artery. If we damage an important artery, critical complications may occur after surgery. Therefore, the preoperative evaluation of the configuration of the hepatic artery and the accurate recognition during operation are considered to be important.

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