Surgery today · 2009
Perioperative challenges associated with a pancreaticoduodenectomy and distal pancreatectomy for pancreatic cancer in patients with situs inversus totalis: report of two cases.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Maruyama Yuichiro, Horiuchi Hiroyuki, Okabe Yoshinobu, Kawahara Ryuichi, Uchida Shinji, Sakai Takenori, Hisaka Toru, Ishikawa Hiroto, Mikagi Kazuhiro, Yoshitomi Munehiro, Kawashima Yusuke, Fujishita Manami, Akasu Gen, Katsumoto Mitsuru, Eto Daimei, Ureshino Mitsutoshi, Goto Yuichi, Ureshino Hiroki, Kinoshita Hisafumi
Аннотация
Situs inversus totalis is a rare anatomic variant of a complete mirror-image transposition of the thoracic and abdominal viscera. The performance of a pancreaticoduodenectomy and distal pancreatectomy in patients with situs inversus totalis is both rare and challenging. We herein present two cases of pancreatic cancer with situs inversus totalis. The abdominal anatomy was preoperatively assessed by multidetectorrow computed tomography, three-dimensional reconstruction, and angiography. We herein report that a pancreaticoduodenectomy and distal pancreatectomy with standard regional lymphadenectomy are feasible in patients with situs inversus totalis. Due to the transposition of the viscera and major blood vessels in such cases, preoperative knowledge of the exact anatomy, mapping of anomalies, and meticulous forward planning are essential for performing these technically difficult and complex hepatobiliary-pancreatic surgeries.