An 80-year-old man with middle-third cholangiocarcinoma associated with celiac axis stenosis underwent pancreaticoduodenectomy. During surgery, the anterior arcade that had developed in the pancreatic head as a collateral pathway between the superior mesenteric artery and the hepatic artery was preserved as a collateral route to ensure adequate hepatic and gastric perfusion. This may be a useful option for pancreaticoduodenectomy in a patient with celiac axis stenosis.
Kishino et al. (Thu,) studied this question.