内容紹介
Summary
This case pertained a 53-year-old man who underwent nab-PTX plus GEM therapy for BR-A pancreatic head cancer. He achieved a partial response and underwent pancreatoduodenectomy. Dynamic CT showed blockage of the original common hepatic artery branching from the celiac artery. Hepatic blood flow was maintained by a pancreatic arcade branching from the superior mesenteric artery which ran along the ventral side of the pancreatic head. The cancer had invaded the same location; therefore, the hepatic artery and portal vein were both resected and reconstructed. The patient had no complications, such as postoperative pancreatic fistula, and was discharged 45 days postoperatively. Currently(5 months postoperatively), postoperative S-1-based adjuvant chemotherapy is being administered, and the patient had a recurrence-free survival.
要旨
症例は53歳,男性。膵頭部のborderline resectable膵癌(BR-A膵癌)に対しnab-paclitaxel(nab-PTX)+gemcitabine(GEM)療法を施行した。PRを得られ,膵頭十二指腸切除術を施行した。dynamic CTでは,腹腔動脈から分岐する本来の総肝動脈は途絶していた。肝血流は上腸間膜動脈から分岐する膵アーケードより維持され,膵頭部腹側を走行していた。同部に浸潤を認め,肝動脈門脈合併切除・再建した。膵液瘻などの合併症は認めず,45日目に自宅退院した。現在,術後5か月でS-1による術後補助化学療法を行い,無再発生存中である。
目次
This case pertained a 53-year-old man who underwent nab-PTX plus GEM therapy for BR-A pancreatic head cancer. He achieved a partial response and underwent pancreatoduodenectomy. Dynamic CT showed blockage of the original common hepatic artery branching from the celiac artery. Hepatic blood flow was maintained by a pancreatic arcade branching from the superior mesenteric artery which ran along the ventral side of the pancreatic head. The cancer had invaded the same location; therefore, the hepatic artery and portal vein were both resected and reconstructed. The patient had no complications, such as postoperative pancreatic fistula, and was discharged 45 days postoperatively. Currently(5 months postoperatively), postoperative S-1-based adjuvant chemotherapy is being administered, and the patient had a recurrence-free survival.
要旨
症例は53歳,男性。膵頭部のborderline resectable膵癌(BR-A膵癌)に対しnab-paclitaxel(nab-PTX)+gemcitabine(GEM)療法を施行した。PRを得られ,膵頭十二指腸切除術を施行した。dynamic CTでは,腹腔動脈から分岐する本来の総肝動脈は途絶していた。肝血流は上腸間膜動脈から分岐する膵アーケードより維持され,膵頭部腹側を走行していた。同部に浸潤を認め,肝動脈門脈合併切除・再建した。膵液瘻などの合併症は認めず,45日目に自宅退院した。現在,術後5か月でS-1による術後補助化学療法を行い,無再発生存中である。