Pancreaticoduodenectomy with Replaced Common Hepatic Artery and Portal Vein Reconstruction in Primary Carcinoma Duodenum: a Case Report and Literature Review

  • Gunjan S. Desai
  • Prasad Pande
  • Rajiv C. Shah
  • Palepu Jagannath
Case Report


The role of combined arterial and superior mesenteric-portal venous resection and reconstruction is not established in primary duodenal carcinoma [1, 2]. Arterial resections tend to result in high morbidity [2]. We present here a case of primary duodenal carcinoma wherein a combined vascular resection and primary repair was performed, along with the possible selection criteria for this procedure and a brief literature review.

Case Report

A 66-year-old lady with no comorbidities, American Society of Anesthesiologists (ASA) 2, and Eastern Cooperative Oncology Group (ECOG) 1 presented with dyspepsia and abdominal discomfort since 6 months. She was diagnosed as primary duodenal adenocarcinoma on esophagogastroduodenoscopy and guided biopsy. Computed tomography (CT) revealed replaced common hepatic artery (RCHA) arising from superior mesenteric artery (SMA) and portal vein (PV) involved in tumor (Fig.  1a, b). The variant arterial anatomy of our case is schematically shown in...


Author Contributions

Gunjan Desai and Prasad Pande have worked for the literature review and the manuscript preparation under the creative inputs, critical evaluation, and guidance of Rajiv Shah and Palepu Jagannath.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from the patient for this publication.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Gunjan S. Desai
    • 1
    • 2
  • Prasad Pande
    • 1
  • Rajiv C. Shah
    • 3
  • Palepu Jagannath
    • 3
  1. 1.Department of Surgical GastroenterologyLilavati Hospital and Research CenterMumbaiIndia
  2. 2.KhargharIndia
  3. 3.Department of Surgical OncologyLilavati Hospital and Research CenterMumbaiIndia

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