Extended pancreatectomy with en bloc resection of the celiac axis for locally advanced cancer of pancreatic body and tail.

At present, most surgeons will not resect the pancreas if there is involvement of celiac axis. We present the case of a 67 yo male with pancreatic body and tail cancer invading the celiac axis treated by extended pancreatectomy, splenectomy, partial resection of proximal portion of jejunum and transverse colon, and left adrenalectomy with en bloc resection of celiac axis. The pulsation in the proper hepatic artery was felt intraoperatively after occlusion of the celiac axis. There were no severe complications. The patient returned home after 32 days stay in the hospital. Severe abdominal pain unresponsive to pain medicines was cured by the procedure and did not return. The patient died of distant disease eleven months after surgery. The case demonstrates that a procedure that may offer cure of locally advanced pancreas cancer may also completely resolve abdominal pain.