case_images: PMC7653469_01
case_images: Preoperative computed tomography (Case #1) showed that.. a: a hypodense lesion in the pancreatic body (black head) and dilation of the distal pancreatic duct (white head).. b: the SMA free from the tumor (white arrow).. c: the presence of the replaced RHA (white arrow).
case_images: gr1.jpg
case_images: PMC7653469_01_gr1.jpg
case_images: fig0005
case_images: The tumor infiltrated the celiac artery (CA) without involvement of GDA (Fig. 1a, b). CT also confirmed the presence of r-RHA (Fig. 1c).
case_images: Operative findings and procedure.. The tumor was found to involve the root of the GDA and the PHA. After confirming complementary arterial flow to the left hemiliver from the replaced RHA through the hepatic hilum, the PHA and the GDA were ligated.
case_images: gr2.jpg
case_images: PMC7653469_01_gr2.jpg
case_images: fig0010
case_images: Finally, we cut the left gastric artery (LGA) and CA, and finished Ex- DP-CAR (Fig. 2).
case_images: Postoperative transaminases.. The postoperative course was uneventful with no evidence of ischemic complications.
case_images: gr3.jpg
case_images: PMC7653469_01_gr3.jpg
case_images: fig0015
case_images: The postoperative course was uneventful, with no ischemic complications, and the patient was discharged 10 days after the surgery (Fig. 3).